Trigger Thumb

What is Trigger Thumb?

Trigger thumb, also known as pediatric flexor tenosynovitis, is a condition where a child’s thumb becomes stuck in a bent position and either clicks, locks, or is difficult to straighten. It is caused by a tight or thickened tendon sheath at the base of the thumb.

Unlike in adults, pediatric trigger thumb is not caused by overuse. It often appears in toddlers and preschoolers and may be noticed when parents observe that their child is unable to straighten the thumb on one or both hands.

Key Facts About Trigger Thumb

• Typically appears between 6 months to 2 years of age
• Often affects only one thumb, but can be bilateral
• May not cause pain, but limits thumb movement
• Most children do not outgrow it without treatment
• Early treatment can prevent stiffness and joint damage

Causes of Trigger Thumb

The condition results from a mismatch between the tendon’s size and the tendon sheath (pulley) through which it moves.

• Congenital (present at or shortly after birth)
• May develop spontaneously during toddlerhood
• Not caused by injury, trauma, or thumb sucking
• Sometimes linked to other hand abnormalities, but usually isolated

Symptoms and Consequences

Common Signs Parents May Notice:

• Thumb remains bent at the tip
• A small lump or nodule felt at the base of the thumb
• Clicking or popping sound when trying to move the thumb
• Child avoids using the affected thumb
• Thumb may lock in a bent position and resist straightening

If Left Untreated:

• Progressive stiffness of the thumb joint
• Permanent contracture or joint deformity
• Delayed hand function and grip development
• Surgical correction becomes more complex with age

Trigger Thumb Treatment at Child OrthoCare

At Child OrthoCare, under the expert care of Dr. Nargesh Agrawal, we provide both non-surgical and surgical options based on your child’s age and severity of the condition.

1. Clinical Diagnosis:

• Based on physical examination
• No need for X-rays or imaging in most cases

2. Conservative Approach (for children under 1 year):

• Observation for spontaneous resolution
• Gentle stretching and hand therapy exercises
• Periodic follow-up to monitor progress

3. Surgical Release (for persistent or locked thumbs):
Outpatient procedure under anesthesia

• A small incision is made to release the tight tendon sheath
• Thumb regains full movement within days
• Stitches removed in 1–2 weeks
• Excellent long-term results with minimal scarring

Did You Know?

• Trigger thumb is not caused by injury or how the child uses their hand
• Many children don’t feel pain, so the condition may go unnoticed for months
• Surgery has a very high success rate, especially when done early
• Children typically regain full use of their thumb within 2 weeks post-surgery

Myths and Facts About Trigger Thumb

Myth: My child’s thumb is stuck because of thumb sucking.
Fact: Thumb sucking does not cause trigger thumb.

Myth: The thumb will correct itself as the child grows.
Fact: While mild cases may improve, most need surgical release after age 1–2 years.

Myth: Surgery is dangerous for such a small joint.
Fact: Pediatric trigger thumb surgery is safe, quick, and highly successful.

Myth: It will affect the entire hand function.
Fact: With early treatment, the rest of the hand functions normally.