Kim So Young, Lee Hyun Il, Yoo Ha-Na, Han Bo Eun, Han Man Yong, Lee Soonchul
Department of Anatomy and Cell Biology, Seoul National University College of Medicine, Seoul, Republic of Korea.
Department of Orthopedic Surgery, Ilsan Paik Hospital, Inje University, 170, Juhwa-ro, Ilsangeo-gu, Goyang-si, 10380, Gyeonggi-do, Republic of Korea.
Sci Rep. 2025 May 15;15(1):16952. doi: 10.1038/s41598-025-01423-2.
Despite extensive research on pediatric trigger thumb, nationwide data on patient characteristics, coexisting birth defects, and development remain limited. This cohort study, using Korean National Health Insurance data, analyzed 1.9 million births (2009-2012) followed to age 6. We identified 10,167 trigger thumb cases and matched them 1:10 by sex and birth year with controls. Baseline features, congenital malformations (International Classification of Disease-10, Q00-Q89), and development at ages 4-6 (Korean Developmental Screening Test) were compared. Conditional logistic regression assessed comorbidity risk, expressed as odds ratio (OR), while generalized estimating equations evaluated the association between trigger thumb and developmental outcomes. The trigger thumb group (average diagnosis age: 31.3 months, 46.6% male) had 32.6% of surgery rate at an average age of 43 months. Trigger thumb group had significantly higher rates of renal agenesis and other reduction defects of kidney (OR 2.95, 95% CI 1.63-5.37), cleft palate (OR 1.79, 95% CI 1.19-2.70), and circulatory system malformations (OR 1.65, 95% CI 1.10-2.49) compared to controls. However, assessment using the Korean Developmental Screening Test revealed no significant delays in development, including gross and fine motor skills. Pediatric trigger thumb is linked to increased congenital malformations but doesn't seem to hinder development. Screening for coexisting conditions and reassuring parents about development are crucial.
尽管对小儿扳机指进行了广泛研究，但关于患者特征、并存的出生缺陷和发育情况的全国性数据仍然有限。这项队列研究利用韩国国民健康保险数据，分析了190万例出生于2009年至2012年的儿童，随访至6岁。我们确定了10167例扳机指病例，并按性别和出生年份以1:10的比例与对照组进行匹配。比较了基线特征、先天性畸形（国际疾病分类第10版，Q00-Q89）以及4至6岁时的发育情况（韩国发育筛查测试）。条件逻辑回归评估合并症风险，以比值比（OR）表示，而广义估计方程评估扳机指与发育结局之间的关联。扳机指组（平均诊断年龄：31.3个月，男性占46.6%）在平均年龄为43个月时的手术率为32.6%。与对照组相比，扳机指组肾缺如和其他肾脏发育不全缺陷（OR 2.95，95%CI 1.63-5.37）、腭裂（OR 1.79，95%CI 1.19-2.70）以及循环系统畸形（OR 1.65，95%CI 1.10-2.49）的发生率显著更高。然而，使用韩国发育筛查测试进行的评估显示，包括粗大和精细运动技能在内的发育没有明显延迟。小儿扳机指与先天性畸形增加有关，但似乎并不妨碍发育。筛查并存疾病并让家长对发育情况放心至关重要。
