The natural history of paediatric trigger thumbs. A prospective cohort study.

Ee Ming Chew, Noah Yu Ting Sim, Nicole Kim Luan Lee, Kenneth Pak Leung Wong, Yi Ling Chua, Dawn Sinn Yii Chia
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Abstract

The aim of this study was to report the natural history of paediatric trigger thumbs, determining the rate and factors predictive of spontaneous resolution. A total of 62 patients presenting with 79 thumbs locked in flexion were observed for a mean of 4.2 years. The median age at presentation was 20.5 months. The spontaneous resolution rate was 37% at 5 years and 50% at 8 years of follow-up. Of the thumbs, 27% had undergone surgery at 5 years and 48% at 8 years. Thumbs that spontaneously resolved did so at a mean of 3.4 years. Thumbs presenting with an interphalangeal joint angle of less than 30° were likely to resolve spontaneously, with a sensitivity of 0.50 and specificity of 0.82. It is reasonable to offer observation alone for 4 to 5 years as the first line of management for paediatric trigger thumb.Level of evidence: III.

小儿扳机指的自然史。前瞻性队列研究
本研究旨在报告小儿扳机拇指的自然病史,确定自发缓解的比率和预测因素。共有 62 名患者的 79 个拇指被锁定在屈曲状态,平均观察时间为 4.2 年。发病时的中位年龄为 20.5 个月。随访5年和8年后,自发缓解率分别为37%和50%。在这些拇指中,27%在5年时接受了手术,48%在8年时接受了手术。拇指自发痊愈的时间平均为 3.4 年。出现指间关节角度小于30°的拇指有可能自行缓解,其敏感性为0.50,特异性为0.82。将单纯观察 4 至 5 年作为治疗小儿扳机拇指的一线疗法是合理的:证据等级:III。
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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