Paediatric Trigger-Locked Thumb

J Hand Surg Asian Pac Vol. 2022 Feb;27(1):2-9. doi: 10.1142/S2424835522300018. Epub 2022 Feb 23.


Paediatric trigger-locked thumb (PT-LT) is a common paediatric thumb condition. It is an acquired flexion deformity of the interphalangeal joint because of a size mismatch between an enlarged flexor pollicis longus tendon and a stenotic oblique pulley. It may present clinically as paediatric locked thumb which is more common or infrequently as paediatric trigger thumb. Paediatric locked thumb is classified into two types based on the presence of metacarpophalangeal joint (MCPJ) hyperextension. Type I does not have MCPJ hyperextension, whereas type II is associated with MCPJ hyperextension. The treatment of PT-LT is determined by the patient's age, time of onset, presentation, and type. Treatment modalities are observation, splinting, therapy, or surgery. Surgery involves dividing the A1 pulley and, most importantly, part of the oblique pulley. Level of Evidence: V (Therapeutic).

Keywords: Child; Congenital trigger thumb; Locked thumb; Trigger finger disorder; Trigger thumb.

Publication types

  • Review

MeSH terms

  • Child
  • Contracture*
  • Humans
  • Metacarpophalangeal Joint
  • Occupational Therapy*
  • Thumb / surgery
  • Trigger Finger Disorder* / surgery
  • Trigger Finger Disorder* / therapy