Treatment Trends in Pediatric Trigger Thumb Among Hand Surgeons, Pediatric Orthopedic Surgeons, and Pediatric Hand Surgeons.

IF 1.8 Q2 ORTHOPEDICS
HAND Pub Date : 2025-03-01 Epub Date: 2023-11-28 DOI:10.1177/15589447231210925
Ashley E MacConnell, Theodore L Schoenfeldt, Christine A Bowman, Alicia M January, Felicity G Fishman
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引用次数: 0

Abstract

Background: The appropriate initial management of pediatric trigger thumb (PTT) remains controversial. Some providers advocate for prolonged nonoperative management, whereas others may offer surgical release to provide a reliable and expedient resolution. The goal of this study was to elucidate the practice patterns of surgeons with different fellowship training who treat patients with PTT. We hypothesized that an association between surgeon specialty training and treatment algorithm would be identified.

Methods: A cross-sectional survey was sent to mailing lists of 3 professional organizations whose members represent most providers caring for pediatric hand patients. Respondents were asked their training background and treatment recommendations for several clinical scenarios. Responses were compared across subspecialties.

Results: Of the respondents, 444 completed a fellowship in hand surgery, 167 completed a pediatric orthopedic fellowship, and 155 completed an additional congenital hand fellowship. Providers with hand fellowship training were more likely to offer surgical intervention as a first-line treatment for a 3-year-old patient with a flexible trigger thumb than those who completed a pediatric orthopedic fellowship (P = .001), and more likely to offer surgical intervention to a 3-year-old patient with an intermittent (P = .007), painful (P = .015), or locked (P = .012) trigger thumb than those providers who completed additional training in congenital hand surgery. No statistically significant differences in practice patterns were appreciated for children aged 6 and 18 months.

Conclusion: Variability was appreciated in practice patterns for initial treatment recommendation for a patient presenting with PTT. Subspecialty training does appear to affect treatment recommendations for clinical scenarios involving a 3-year-old patient with PTT, although this trend is not observed when treating younger patients.

手外科医生、小儿骨科医生和小儿手外科医生治疗小儿触发拇指的趋势。
背景:儿童触发拇指(PTT)的适当初始处理仍然存在争议。一些医生提倡延长非手术治疗,而另一些医生可能会提供手术释放,以提供可靠和方便的解决方案。本研究的目的是阐明不同培训背景的外科医生治疗PTT患者的实践模式。我们假设外科医生专业训练和治疗算法之间的关联将被确定。方法:对3个专业组织的邮件列表进行横断面调查,这些组织的成员代表了大多数护理小儿手部患者的提供者。受访者被问及他们的培训背景和几种临床方案的治疗建议。对不同亚专科的反应进行比较。结果:在受访者中,444人完成了手外科奖学金,167人完成了儿科骨科奖学金,155人完成了额外的先天性手奖学金。接受过手部研究金培训的医生比接受过儿科骨科研究金培训的医生更有可能为3岁的灵活的触发拇指患者提供手术干预作为一线治疗(P = 0.001),并且比那些接受过先天性手外科额外培训的医生更有可能为3岁的间歇性(P = 0.007)、疼痛(P = 0.015)或锁定(P = 0.012)的触发拇指患者提供手术干预。6个月和18个月的儿童在练习模式上没有统计学上的显著差异。结论:对于PTT患者的初始治疗推荐,实践模式的可变性值得赞赏。亚专科培训似乎确实会影响3岁PTT患者的临床治疗建议,尽管在治疗年轻患者时没有观察到这种趋势。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
HAND
HAND Medicine-Surgery
CiteScore
3.30
自引率
0.00%
发文量
209
期刊介绍: HAND is the official journal of the American Association for Hand Surgery and is a peer-reviewed journal featuring articles written by clinicians worldwide presenting current research and clinical work in the field of hand surgery. It features articles related to all aspects of hand and upper extremity surgery and the post operative care and rehabilitation of the hand.
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