The Natural History of Congenital Trigger Thumbs
| Status: | Completed |
|---|---|
| Conditions: | Neurology |
| Therapuetic Areas: | Neurology |
| Healthy: | No |
| Age Range: | Any - 5 |
| Updated: | 8/17/2018 |
| Start Date: | December 2010 |
| End Date: | June 2018 |
This will be a prospective study of all children ages 0 - 5 years old at the time of entry
into the study that meet the inclusion criteria who present with congenital trigger thumb.
Patient records will be reviewed for eligibility before obtaining parental permission. They
will be enrolled in the study at their first visit and followed every year for up to 4 years
or until one of the exclusion criteria are met. Participating sites include the University of
Utah Orthopaedic Center, Primary Children's Medical Center and Shriners Hospital for
Children.
into the study that meet the inclusion criteria who present with congenital trigger thumb.
Patient records will be reviewed for eligibility before obtaining parental permission. They
will be enrolled in the study at their first visit and followed every year for up to 4 years
or until one of the exclusion criteria are met. Participating sites include the University of
Utah Orthopaedic Center, Primary Children's Medical Center and Shriners Hospital for
Children.
Trigger thumb is a stenosis tenosynovitis of the flexor pollicis longus tendon of the thumb1.
The eitiology of congenital trigger thumb is unclear with many authors proposing both
hereditary and acquired causes2-4. Surgical release of congenital trigger thumbs has been
recommended as definitive treatment, though controversy exists over the natural history of
congenital trigger thumbs5-8. There have been a number of studies looking at the natural
history of congenital trigger thumbs with spontaneous resolution rates ranging from 0-96%
over a median duration of follow up that ranged from 6 months to 48 months9-14. Based on our
clinical experience, the investigators do not feel that congenital trigger thumbs resolve
spontaneously and that definitive treatment requires surgical release. However, the
investigators need to do further scientific research into the natural history of trigger
thumbs to determine how often trigger thumb resolves without needing surgical intervention.
The eitiology of congenital trigger thumb is unclear with many authors proposing both
hereditary and acquired causes2-4. Surgical release of congenital trigger thumbs has been
recommended as definitive treatment, though controversy exists over the natural history of
congenital trigger thumbs5-8. There have been a number of studies looking at the natural
history of congenital trigger thumbs with spontaneous resolution rates ranging from 0-96%
over a median duration of follow up that ranged from 6 months to 48 months9-14. Based on our
clinical experience, the investigators do not feel that congenital trigger thumbs resolve
spontaneously and that definitive treatment requires surgical release. However, the
investigators need to do further scientific research into the natural history of trigger
thumbs to determine how often trigger thumb resolves without needing surgical intervention.
Inclusion Criteria:
- Diagnosis of congenital trigger thumb based on physical exam and history, no previous
treatment history (either operative or non-operative), no pain associated with the
deformity, no functional disability due to the trigger thumb.
Exclusion Criteria:
- Previous operative treatment for the congenital trigger thumb, deformity of the thumb
that causes pain, triggering that causes secondary deformity of the thumb, and
deformity that prevents normal use of the thumb and hand.
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