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Splint Therapy for Trigger Thumb in Children

Sometimes young children between the ages of one and four develop a trigger thumb. With trigger thumb, the tip of the thumb is stuck in a flexed position. The thumb snaps or locks in this bent position. The exact cause of the problem is unknown. It is not congenital (present at birth).

In this study, a special splint was used to reduce the thumb. This means the joint was moved into an extended position and held there. The child wore the splint all day for six to 12 weeks. A special night splint was worn after that to keep the trigger thumb from coming back.

The children were rated afterwards as cured, improved, or unimproved. Cured was defined as full motion with no snapping. Improved was full motion with only one snapping episode each week. No change with snapping and persistent thumb flexion was labelled unimproved.

Results were compared for children with splints and children who were treated by observed only (no splints or other treatment). Two-thirds of the splinted group were cured or improved. Less than one-fourth of the observed group were cured or improved. Younger children were more likely to be cured or improved in both groups.

The children who did not improve went on to have surgery to release the tendon. All were cured. Delaying surgery by using splinting first did not affect the results of surgery.

The authors suggest trying splinting for children with trigger thumb. Surgery is not urgent and can be easily postponed.

References: Zhon-Liau Lee, MD, et al. Extension Splint for Trigger Thumb in Children. In Journal of Pediatric Orthopaedics. November/December 2006. Vol. 26. No. 6. Pp. 785-787.

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