Trigger thumb/trigger finger

In this condition, the thumb or another finger gets stuck in a bent position, affecting the movement and function of a child’s hand.

About trigger thumb and trigger finger in kids

This condition, also known as stenosing tenosynovitis, affects 3 in 1,000 children. It develops because of a problem with the tendons and ligaments, which are fibrous bands of connective tissue. Normally, the ligaments in a child’s finger wrap around the tendon, and the tendon slides through the ligament tunnel as the child flexes and straightens their finger. In trigger thumb or trigger finger, the tendon can’t move smoothly, and the child can’t fully straighten their thumb or finger as a result. This condition gets its name from the popping/clicking sensation that can occur when a child’s tendon catches. In trigger thumb — the most common finger affected in kids — the problem occurs at the IP joint near the end of the thumb. A child might have trigger thumb or trigger finger in one or both hands.

Experts in trigger thumb and trigger finger

As the only comprehensive pediatric hand and upper extremity program in the state, Children’s Wisconsin provides expert care to kids and teens with a wide range of common and rare conditions affecting the shoulder, arm, elbow, wrist and hand. With our team’s specialized training, vast experience and deep knowledge of the unique challenges of children’s growing bodies, we can ensure the best possible outcomes for a child with trigger thumb or trigger finger. As Wisconsin’s highest-rated pediatric surgery center, our board-certified surgeons use the most advanced techniques and technology. Our child-centered environment and wraparound services are designed to support the whole family and provide comfort during treatment and beyond. If your child has already been diagnosed at another center, we invite you to get a second opinion at Children’s Wisconsin.

What causes trigger thumb and trigger finger in kids?

This condition usually occurs suddenly in early childhood. For whatever reason, some kids’ ligaments become too tight, making the tendon swollen and thicker than normal. Sometimes the tendon forms a bump known as a Notta’s nodule. This prevents the tendon from moving normally through the ligament tunnel.

Why is trigger thumb and trigger finger a concern?

While this condition doesn’t cause serious problems, a fully functional hand is vital to how children learn, move and play. For that reason, it’s usually recommended that trigger thumb and trigger finger be treated early, usually between ages 1-3. If left untreated, this condition could cause the muscle or tendon to permanently shorten, affecting your child’s hand function and range of motion.

What are the symptoms of trigger thumb and trigger finger?

Signs of this condition may include:

• Inability to completely straighten thumb or finger
• Noticeable bump at the inside base of the thumb
• Popping/clicking sensation or sound when the thumb or finger is moved
• In rare cases, there may be pain/swelling at the thumb base

How is trigger thumb and trigger finger diagnosed?

The physician will evaluate your child’s hand through a physical examination. X-rays and other imaging usually aren’t needed to diagnose this condition.

Treatment for trigger thumb and trigger finger

In children under age 1, this condition sometimes resolves on its own. In other cases, our hand/upper extremity expert may recommend one or more of the following:

Hand therapy/splinting  – Our certified hand therapist offers custom splinting, paraffin wax treatments, massage and more to promote healing, increase range of motion and maximize functional use of your child’s hand.

Surgical repair – If your child’s affected finger doesn’t respond to stretching and splinting, the doctor might recommend an outpatient surgical procedure. Using a small cut at the base of the thumb, our highly skilled pediatric hand surgeon will cut the tight ligament (the A1 pulley) so that the tendon can move smoothly. Your child will need to wear a bandage for 1-2 weeks after the procedure and can soon resume normal activities.

Long-term outlook for trigger thumb and trigger finger

With proper treatment by a pediatric hand expert, most cases of trigger thumb and trigger finger are easily treated and don’t cause long-term problems. It is rare for the condition to return after surgical repair.