Background

Although trigger finger is routinely observed in adults, it is encountered much less frequently in pediatric patients. The thumb followed by the middle finger are the digits most commonly affected. Typically, a trial of nonsurgical management is attempted initially. If nonsurgical management fails, then surgical release, consisting of stepwise evaluation of the flexor tendon system, can be undertaken. The goal of this video is to outline the surgical technique for trigger finger release in pediatric patients and the unique technical considerations associated with the procedure.

Methods

The case presentation of a 3-year-old boy with trigger finger of the right thumb, right long finger, and left long finger is discussed. Nonsurgical treatment was unsuccessful; therefore, the patient underwent release of the right thumb A1 pulley, the right long finger A1 pulley, and the ulnar slip of the right flexor digitorum superficialis. At 4 months postoperatively, the patient had persistent trigger finger of the left long finger and underwent release of the left long finger A1 pulley. Postoperatively, the patient's arm was immobilized in a long arm cast for 2 weeks for surgical site protection.

Results

At a follow-up of 6 weeks, the patient had increased range of motion and cessation of trigger finger bilaterally.

Conclusion

Trigger finger release with stepwise evaluation of the A1 pulley and the ulnar slip of the flexor digitorum superficialis may be an effective and safe treatment option for pediatric patients with trigger finger. This video demonstrates the key steps and considerations for the technique.