Treatment of trigger finger in children

The article was professionally consulted with Master, Doctor Truong Thanh Tam - Pediatrician - Department of Pediatrics - Neonatology - Vinmec Danang International General Hospital.

Diagnosis should be based on history and physical examination, laboratory tests are not helpful:
History: Fingers are a bit stiff, difficult to flex, and a clicking sound is heard when straightening. In more severe cases, the fingers may become locked in the folded position. Clinical: The locked finger is seen in the flexed or extended position, when moving, there is a clicking sound. The tumor is palpated at the position of tendon jam, the surface of the vertebral column. Subclinical: Ultrasound of the trigger finger to evaluate the thickness of the pulley and tendon nodules. Before performing a hand exam, your doctor will need to take a complete medical history. The severity of trigger finger disease in children and the child's condition is classified as follows:
Grade I: There is evidence of inflammation in the A1 pulley tissue area of ​​the finger. disability, but no obvious pop-up was detected. Grade II: There is evidence of inflammation in the A1 pulley tissue area of ​​the affected finger with obvious finger pop when the child is asked to straighten the finger in a fully flexed position. Grade III A: Grade II shows similar observations, but in addition, the child is unable to fully extend the finger because the finger is locked in the flexion position and can only be extended with the other hand. for removal Grade III B: The child is unable to fully flex the toe due to severe inflammation in the fascia A1 Grade IV: Presence of a fixed flexor deformity in the proximal interphalangeal joint due to prolonged inflammation

There are 3 methods to treat trigger finger in children:
2.1 Non-surgical, non-invasive treatment With this method, the patient must use a course of non-steroidal anti-inflammatory drugs combined with hand therapy, splints, and activity correction. In general, this method is only applied to patients with this syndrome for the first time or patients in stage I or early stage II.
Start treatment by splinting the extensor joint for 10-14 days. Non-steroidal anti-inflammatory drugs can be used or corticosteroids are injected into the tendon membrane. Patients with mild disease can visit a doctor specializing in rheumatology and orthopedics for treatment with anti-inflammatory drugs. 2.2 Non-surgical, invasive treatment With this method, it is necessary to inject directly into the membrane surrounding the flexor tendon. The injection contains a mixture of a local anesthetic and a corticosteroid preparation. This mixture will help cure inflammation in the A1 pulley tissue area and alleviate trigger finger disease in children. The effect can be short or long-lasting and there is always the possibility of disease recurrence.
However, do not inject too many times. Orthopedic doctors recommend a maximum of 2 injections into 1 disabled finger, except for the little finger, only 1 injection is required. It is believed that corticosteroids can weaken tendons and lead to mild rupture (tearing) of the tendon if given too many times.

This treatment is recommended if non-invasive methods are not effective and for grade II or III disease.
2.3 Surgical intervention Once diagnosed, the treatment will be to release the trapped tendon:
With this method, the A1 pulley tissue area, circular pulley tissue and even part of the tissue pulley A2 is removed through a small incision at the base of the finger; The time of surgery will be decided by the doctor. Currently, surgery can be performed at any age depending on the severity of the disease; At a young age, this will be done under anaesthesia, the duration of anesthesia is short, 5-10 minutes; Make a small incision of 0.5 - 1cm in the skin to release the action of the flexor tendon; After surgery, the child woke up quickly, was discharged within the same day, the incision was small, healed well, no infection or bad scar was recorded; Combined with physical therapy, the rate of movement recovery is almost absolute; However, parents should take their baby to the doctor as soon as possible, because if left for a long time, the flexor tendon can contract, making treatment much more difficult. Recurrence of trigger finger in children after surgery is very rare. When the disease is in grade IV, the doctor may perform an additional procedure to release the proximal interphalangeal joint, the joint between the finger bones that allows the finger to bend into the palm of the hand. Your doctor will need to make another incision above this joint to perform the procedure.

Parents need to know about trigger finger disease and how to treat it, and at the same time need to closely observe their children's hands to promptly detect the disease so that the treatment and rehabilitation of children's hands can be better.
You should take your baby to a reputable medical facility with good and adequate rehabilitation medical equipment to get the best treatment effect. Vinmec International General Hospital is a high-quality medical facility in Vietnam with a team of highly qualified medical professionals, well-trained, domestic and foreign, and experienced.
A system of modern and advanced medical equipment, possessing many of the best machines in the world, helping to detect many difficult and dangerous diseases in a short time, supporting the diagnosis and treatment of doctors the most effective. The hospital space is designed according to 5-star hotel standards, giving patients comfort, friendliness and peace of mind.