Pediatric Trigger Thumb & Finger

Percutaneou Needle Release Treatment

If the thumb has painless triggering and is not locked, spontaneous resolution may be observed. However, if the thumb is locked or is painful during movement, percutaneous release under local anesthesia is indicated.

On an outpatient basis, the child is taken to the procedure room with his or her parents, the nodule site is numbed with a fine needle (local anesthesia).

Although the child feels no pain during the release, he or she may cry due to the unfamiliar environment or fear. With a needle's tip the sheath over the nodule is severed percutaneously. There is no incision, no sutures. The procedure takes 2-3 minutes, immediately restoring normal thumb movement.

Pediatric trigger finger also can be treated in the same manner.

Pediatric trigger thumb is a rare condition, and percutaneous (incision-free) treatment is not yet widely adopted globally. My surgical technique, developed through a decade of experience and hundreds of cases, was published in the Journal of Pediatric Orthopaedics in November 2023.

Post Operative Guidelines

We apply a thin bandage and request the parents to take it off the next morning, afterwards they can wet the hand. There are no restrictions for hand and finger movement and generally most children use their hand normally.

However, some children may not use their hand actively for two weeks, in this case we recommend parents to observe the child, if the thumb is consantly in a bent position and there is no active straightening (extension) they should stretch the child's thumb once while he or she is in deep sleep at night.

Risks and Complications

This procedure is low risk; serious complications are rare because there is no incision, suturing or general anesthesia. Among 431 pediatric cases I have treated, recurrence occurred only in three cases, and inadequate release in two. All were successfully treated with a second percutaneous procedure, and no significant complications were observed. Our success rate is 97% and non of our pediatric patients required open surgery. We have had no neurovascular complication at all.