Sleiay Mouhammed, Alsaleh Malak, Alsmoudi Hasan, Aldakkak Raghad, Alsalloum Ayat, Dabeek Nour, Alkhameed Fadi, Alsaleh Khaled, Hamad Alokla Abdulrahim, Ashkar Haitham, Alqreea Mohammed, Kojak M-Jaber, Bitar Abdulkader
Faculty of Medicine, University of Hama, Hama, Syria.
Orthopedic Surgery Department, Pushkin Clinical Hospital, Ivanteevka, Russia.
Ann Med Surg (Lond). 2025 Apr 22;87(6):3931-3934. doi: 10.1097/MS9.0000000000003313. eCollection 2025 Jun.
Congenital trigger thumb, affecting approximately 0.3% of children, is characterized by a locked interphalangeal joint and can result from a mismatch between the flexor tendon and thumb pulley system. Though typically diagnosed in early childhood, late diagnosis can occur, as demonstrated in this case. Understanding the differential diagnoses and clinical presentation of trigger thumb is crucial for effective management, particularly when symptoms persist into adolescence.
A 17-year-old female presented with a long-standing inability to hold a pen due to a flexion contracture of both thumbs, preventing full extension of the metacarpophalangeal joints. Despite the condition's presence since childhood, it had not been diagnosed until adolescence. Radiographs revealed excessive extension at the carpometacarpal joints. The patient had no significant medical history or accompanying symptoms.
This case highlights an unusual presentation of congenital trigger thumb diagnosed in late adolescence. Typically identified in infancy, late diagnoses may complicate early treatment and long-term management. Surgical intervention, including the A1 pulley release, effectively restored thumb function and resolved the deformity. This case underscores the importance of considering congenital trigger thumb in older children or adolescents with unexplained thumb deformities.
Late diagnosis of trigger thumb is rare but important to recognize, as timely surgical intervention can effectively restore functionality. Awareness of this condition beyond infancy is essential for comprehensive clinical care.
先天性扳机指影响约0.3%的儿童，其特征为指间关节锁定，可能由屈肌腱与拇指滑车系统不匹配所致。虽然通常在幼儿期被诊断，但也可能出现延迟诊断，本病例即如此。了解扳机指的鉴别诊断和临床表现对于有效管理至关重要，尤其是当症状持续到青春期时。
一名17岁女性因双侧拇指屈曲挛缩导致长期无法握笔，掌指关节无法完全伸直。尽管该病症自童年就存在，但直到青春期才被诊断出来。X线片显示腕掌关节过度伸展。患者无重大病史及伴随症状。
本病例突出了在青春期后期诊断出的先天性扳机指的不寻常表现。通常在婴儿期被发现，延迟诊断可能使早期治疗和长期管理复杂化。手术干预，包括A1滑车松解术，有效恢复了拇指功能并矫正了畸形。本病例强调了在患有不明原因拇指畸形的大龄儿童或青少年中考虑先天性扳机指的重要性。
扳机指的延迟诊断虽罕见但需识别，因为及时的手术干预可有效恢复功能。认识到婴儿期以外的这种病症对于全面的临床护理至关重要。
