Some parents may occasionally find that their child’s thumb is not straight, or after massage can be straightened but soon stuck again, what is going on? It turns out that the child has a popping thumb. It is a common condition in children, as the affected finger is flexed like a trigger and has a popping sound, also known as “trigger finger”, also known as “congenital stenosing tenosynovitis”, which is a congenital disease unique to infants and children. As the flexor tendon is located at the distal end of the metacarpophalangeal joint, the tendon is narrowed by the narrow fibrous lesion of the tendon sheath, causing the proximal tendon to thicken or become nodular, causing the interphalangeal joint to be in a flexed position and unable to straighten actively, causing pain or popping sound when it is passively extended. Sun Jun of the Department of Pediatric Orthopedics at Anhui Children’s Hospital is not usually symptomatic at birth, and it is common for children aged 6 months to about 2 years to exhibit flexion of the fingers and inability to straighten them, with the most common sites being the metacarpophalangeal joints of the thumb, second and third fingers, where rounded raised nodules can be palpated, with light pressure pain and a bouncing sensation when extending and flexing, while the interphalangeal joints are fixed in flexion and have a bouncing sensation when moving and extending. However, it is often not taken seriously by parents and is not seen until the age of about 2 years or even older. This leads to severe finger deformation and dysfunction of the infant thumb, which has a significant impact on the long-term hand function of the child. Because thumb function accounts for 40% of total hand function
Therefore, patients with congenital stenosing tenosynovitis of the infant thumb who present with clinical symptoms of strangulation or popping indicate that there is no possibility of self-healing and should be treated with early surgery to avoid affecting the function and development of the affected thumb. Surgery is generally appropriate for treatment within two years of age. The surgery is performed under direct vision to completely release the narrow tendon sheath and restore the normal movement of the thumb, while effectively avoiding damage to the blood vessels and nerves. The postoperative period needs to be accompanied by strengthening functional exercises with good results.