Long-term follow-up of surgical release of the A(1) pulley in childhood trigger thumb.

Trigger thumb is an uncommon problem in infants and children. The authors reexamined 21 patients (30 thumbs) who underwent a release procedure, with an average follow-up of 181.3 months (15.1 years). Twenty-three percent of patients had a loss of interphalangeal motion and 17.6% had metacarpal phalangeal hyperextension, and this was unrelated to age at the time of surgery. There was no recurrence of triggering or nodules and no functional deficit. All seven patients who had a longitudinal incision had concerns about their scar appearance. It is the authors' belief that a transverse skin incision and surgical release of the A(1) pulley for trigger thumb in children is a successful procedure even when done after age 3, but interphalangeal motion loss and metacarpal phalangeal hyperextension may occur in the long term.