Mummy Shun hadn’t realised that her daughter’s thumb looked different, “My mum noticed it first, maybe because I had the same issue when I was young.”
Her toddler’s thumb was constantly bent, and couldn’t be straightened easily, unless massaged for a long time. “But even after being straightened, it pops back to the bent position after a while”, she adds.
She took her to a specialist at KK Hospital (KKH), and discovered that her daughter had “Trigger Thumb.”
Singapore toddler has ‘Trigger Thumb’
Image source: C. Noel Henley
Trigger Thumb basically means that your child’s thumb pops, clicks or catches when they try to straighten it. Their thumb may lock in a bent position.
If the thumb locks, your child can pull it straight using their other hand. Or you can help pull it straight for them. But importantly, they are unable to straighten the locked thumb using their thumb muscles.
Image source: Geelong Hand Therapy
Apparently, in children, trigger thumb usually happens between the ages of one and three years old. Occasionally, the problem will correct spontaneously over time, and no other treatment is needed.
Dr Anthony Foo, Consultant, Hand & Reconstructive Microsurgery Centre, National University Hospital, tells us that, “The cause of the trigger thumb is due to tendon swelling, known as Notta node. The exact nature of this node, be it congenital or developmental is unclear, as the flexed thumb is often noted months later, when infants start interacting more frequently with their hands.”
“The trigger thumb may be mild, where the flexed position is easily straightened and is flexible, to its more advanced form where the thumb is permanently flexed and not passively correctible.”
Dr. Foo adds, “Data from National University Hospital Hand Centre estimates the incidence of trigger thumb at 15 per 1,000 cases.”
Locked thumb (left) and nodular swelling of the tendon (black arrow) during surgery. | Source: NUH
Treatment options for Trigger Thumb
When asked if Trigger Thumb was painful, Mummy Shun tells us, “It doesn’t usually bother her. But it does hurt when stretched on purpose.”
So is the child restricted in any way due to the trigger thumb?
Dr. Foo informs us, “The severity of the trigger thumb may not directly affect children’s ability to perform various tasks as they compensate well with the other fingers.”
What are the treatment options for Trigger Thumb in Singapore?
According to Dr. Anthony Foo, “The mainstay of treatment for trigger thumb is splinting, and up to half will recover within a year or two. Surgery may be considered in cases where splinting was not effective, the thumb is constantly locked, and where the child’s dexterity is clearly affected.”
He continues, “Age, thumb size, and developmental milestones are the key factors for consideration in decision making for surgery. Most hand surgeons would consider performing the surgery before pre-school to minimise the stigma of physical difference as children integrate themselves amongst their peers.”
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Additional source: Seattlechildren’s.org