Trigger Thumb

In children, a trigger thumb forms when a little lump (a Notta’s node) forms on the main tendon that flexes (bends) the thumb. This may make it uncomfortable for your child to move their thumb and may catch in a bent position either occasionally or most of the time. This can affect your child’s ability to use their hand and may have an impact on the patterns of hand movement they develop. Your child’s finger or thumb may pop or click when they try to straighten it.

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In very young children, trigger thumb or finger will resolve on its own for up to 30 percent of children before they reach their first birthday. After that age, it’s unlikely this condition will go away without treatment. Ultrasound can help confirm the diagnosis by demonstrating the node on their tendon.

Surgery to correct trigger thumb is usually performed when a child is between 1 to 2 years of age (before 3 years). In this procedure, your child’s surgeon will release the tendon from the tendon sheath where it is catching, allowing the tendon to glide more smoothly.

Treatment of trigger fingers other than the thumb will include evaluation for any underlying inflammatory condition. Treatment most commonly involves releasing one of the tendon pulleys of the thumb to allow the tendon to glide more smoothly. There are important nerves and vessels nearby, which is why it is important that the surgery is performed by a qualified hand surgeon, like those at RPS.

Your child will be able to go home the same day as her trigger finger or trigger thumb release surgery. She will need to leave a soft dressing over the incision for five days after surgery. Use of the affected hand will be restricted during this time, but they should be able to return to more normal movement and activity within a few weeks.

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What are the signs and symptoms of Trigger Thumb in my child?

Some common signs of trigger finger and thumb include:

  • Stiffness in the affected finger or thumb
  • A painful popping or clicking when the finger or thumb is bent and straightened
  • A finger or thumb that gets stuck in either a bent or straight position
  • Symptoms that are worse in the morning

In some cases, these symptoms may be associated with an inflammatory condition such as juvenile idiopathic arthritis.

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What is the treatment for Trigger Thumb for my child?

In very young children, trigger thumb or finger will resolve on its own for up to 30 percent of children before they reach their first birthday. After that age, it’s unlikely this condition will go away without treatment.

Surgery to correct trigger thumb is usually performed before your child turns 3 years of age. In this procedure, your child’s surgeon will release the tendon from the tendon sheath where it is catching, allowing the tendon to glide more smoothly.

Treatment of trigger fingers other than the thumb will include evaluation for any underlying inflammatory condition. Treatment may include surgical removal of a part of the tendon or decompressing the tendon sheath to allow the tendon to glide more smoothly.

Your child will be able to go home the same day as her trigger finger or trigger thumb release surgery. She will need to leave a soft dressing over the incision for five days after surgery. Use of the affected hand will be restricted during this time.

Once the dressing is removed, your child will be able to use her hand normally and without restriction. The absorbable sutures used during surgery will fall out on their own within two weeks of surgery.

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What else you should know

How will RPS manage my child's post-operative care?

RPS will give you specific advice regarding your child’s individual post-operative recovery. They will advise:

  • where your child will go after their surgery
  • what medication your child will be given or prescribed
  • what bandages and dressings your child will need and when they’ll be removed
  • when the stitches will dissolve or need to be removed
  • when your child can get back to normal activity and exercise
  • when to book follow-up care for my child
How do I care for my child at home?

After returning home from surgery you should follow the post-operative instructions provided by the RPS team.

Remember, everyone recovers differently, but you can follow these general steps to optimise healing.

Medicine

  • Always speak with your RPS team to find out when you can recommence giving your child any existing medication and before starting any new medicine they have prescribed.
  • Always consult the RPS team before taking new medication, even if it’s over-the-counter.
  • Always follow the instructions provided with the medication.

Activity

  • When you have stitches, always check with the RPS team before your child returns to their normal activities.
  • After a skin graft, any exercise that stretches the skin should be avoided for at least three weeks.

Caring for your child’s wound

  • The wound will have a dressing covering it to help it heal and protect it from outside elements. If your child had a skin graft you may need to change the bandages. The post-operative instructions given to you will outline how to care for your child’s wound.
  • If your child had stitches, the RPS team will let you know when or if you have to return to have them removed. In most cases, absorbable (dissolving) sutures are used in children so they do not have to have sutures removed.
  • Wash the area daily with warm, soapy water and pat it dry. Ensure you don’t use any alcohol or hydrogen peroxide which can slow down the healing process.
When should I call for help?

Notify your health care team immediately if your child experiences any of the following symptoms:

  • nausea, vomiting or diarrhoea
  • fever/high temperature – 38°C or higher
  • your child’s stitches become loose or the wound opens
  • increasing pain that doesn’t improve with medication
  • increasing warmth, swelling or redness around incision site
  • pus coming from the incision site
  • heavy bleeding from incision site
  • red streaks leading to the incision site
  • your child can’t pass stools or gas
  • signs of a blood clot including pain in the calf, back of the knee, groin or thigh, redness or swelling in their leg.

If your child faints or is short of breath call 000 for emergency care.

Our Canberra specialists

The team at RPS Canberra are committed to providing you with the best possible outcome.

The extensive specialist skills of our surgical team ensure that you are provided with surgical options designed to maximise form and function.

Our surgeons hold an impressive array of academic credentials, extensive professional experience and a personal commitment to patient satisfaction.

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