The natural history of pediatric trigger thumb: a study with a minimum of five years follow-up.
BACKGROUND
Pediatric trigger thumb is due to deformed flexion of the interphalangeal joint. We previously reported that pediatric trigger thumb can spontaneously resolve in > 60% of patients at the median follow-up of 48 months. The purpose of this study was to determine whether there were any more cases of resolution with a follow-up of more than 5 years and whether any residual deformities remain, and so to confirm the natural history of pediatric trigger thumb.


METHODS
We prospectively followed 87 thumbs in 67 patients with pediatric trigger thumb and these patients didn't receive any treatment such as passive stretching, splinting or surgery. The date of the first visit ranged from April 1994 to March 2005. The patients were evaluated every six-months prior to resolution and annually after resolution. The median duration of follow-up was 87.3 months (range, 60 to 156 months).


RESULTS
Of the 87 trigger thumbs, 66 (75.9%) resolved spontaneously. The median time from the initial visit to resolution was 49.0 months (95% confidence interval, 41.1 to 56.9). There were no residual deformities that resolved beyond 48 months. Although complete resolution did not occur in the remaining 21 thumbs, the flexion deformities did improve in all 21 thumbs. There were no other differences between the two groups besides the average duration of follow-up. There was no difference in resolution based on gender.


CONCLUSIONS
Pediatric trigger thumb can spontaneously resolve in > 75% of the cases after a follow-up period of at least 5 years. An operation may be delayed or avoided in the majority of cases. This may help both the families and the surgeons make decisions regarding the proper treatment of pediatric trigger thumb.
['Baek|Goo Hyun|GH|', 'Lee|Hyuk Jin|HJ|']
D000293:Adolescent D002648:Child D002675:Child, Preschool D005260:Female D005500:Follow-Up Studies D006801:Humans D007223:Infant D053208:Kaplan-Meier Estimate D008297:Male D012075:Remission, Spontaneous D018709:Statistics, Nonparametric D013997:Time Factors D052582:Trigger Finger Disorder
Natural history Pediatric trigger thumb Conservative management