Congenital stenosing tenosynovitis of the flexor tendon in infants and children occurs overwhelmingly in the thumb, with a slight increase in females. The detailed pathogenesis is not known, but it is assumed that the thumb is continuously hyperflexed while the fetus is in the mother’s womb, resulting in narrow compression at the entrance to the palmar fibrous sheath of the metacarpophalangeal joint and enlargement of the proximal flexor tendon, making it difficult for the tendon to pass through the sheath. If the interphalangeal joint of the thumb is flexed and the thumb is forced to straighten passively, a “trigger” pops and the child cries. It is usually noticed by the mother a few months to a few years after birth, or by the physician during a hospital visit for other conditions. In infants with congenital stenosing tenosynovitis of the finger flexor tendons, Cambell advocates further observation. Because many children heal spontaneously within 6 months of age, almost all affected children heal spontaneously within 2 years. In 1978, Daozhen et al. reported a group of follow-up results in which 78% of children had spontaneous healing after 3-4 years; those who could not heal spontaneously could be treated without surgery until the age of 5 years, but those who developed limited extension of the interphalangeal joint of the thumb after 10 years required surgical treatment. Generally speaking, after the diagnosis of congenital stenosing tenosynovitis of the flexor tendon, intrathecal steroid injection and interphalangeal joint extension brace fixation can be performed first. After these conservative treatments, most of the symptoms can be relieved until they disappear. When conservative therapy is not effective, surgery is feasible. Indications for surgery: 1, recurrent, long-standing stenosing tenosynovitis, after local closure and other conservative treatment does not work. 2, congenital finger flexor tendon stenosing tenosynovitis observed for more than 2 years can not be self-healing, or by conservative therapy is ineffective. Congenital trigger finger The gliding of the flexor tendon is blocked in the flexor tendon sheath, resulting in a congenital trigger finger, unlike adult stenosing tenosynovitis, which is usually manifested as a persistent flexion deformity of the finger, but not a real “trigger finger”. These cases are rare, accounting for only 2.3% of cases in Flatt’s statistics. This deformity is most common in the thumb and is bilateral in 25% of cases. The disease is disseminated and is not genetically related. Typically, it is not associated with other malformations but has been reported with triplication of chromosome 13. Van HeesL has also described the disease in association with mucopolysaccharide deposition disorder. Trigger finger in children is more commonly acquired, and although the Dinham and Megitt study showed that approximately 25% of trigger fingers were detected at birth, not a single case of simple congenital trigger thumb was found in a retrospective study of 5765 newborns. This condition is often detected at 1-2 years of age, when the interphalangeal joints of the thumb are relatively fixed in a flexed position, and even full extension of the interphalangeal joints of the thumb is not possible under certain external forces. Dellon and Hansen reported that the thumb was occasionally in the extended position with multiple finger onset. Unlike in adults, an abnormal clicking or popping sound is not the patient’s chief complaint. This deformity must be differentiated from the hooked thumb deformity, which primarily presents with flexion of the metacarpophalangeal joint. Pathologic anatomy of the trigger finger reveals tendon sheath narrowing, thickening, and occasionally tendon sheath cysts. Intertendinous nodules may be present at the proximal end of the 1st talon. Chronic inflammation is also common. There is no fixed contracture if it subsides or is corrected before 3 years of age. It resolves spontaneously in 30% of patients whose symptoms appear within 1 year of age and in 12% of those whose symptoms appear between 6 months and 2 years of age. Several articles have highlighted the differences between congenital trigger finger and trigger thumb. Trigger finger is not often associated with a fixed flexion deformity, and more importantly, release of the slide A is not effective for it. When performing surgery, the surgeon should be prepared to extensively explore the flexor apparatus, including removal of one or two superficial flexor tendon bundles and release of the slide A3. Treatment: Because 30% of children who present with significant symptoms within 1 year of age resolve on their own, observation and gentle manipulation should be performed. Splinting is not effective. If the symptoms do not resolve spontaneously, surgical treatment must be performed before 3 years of age. If there is no spontaneous resolution, surgical release of the 1st circumferential carriage should be performed around 2 years of age. In rare cases, there are multiple trigger fingers at the same time, making the child unable to make a fist, and surgery must be performed as early as possible (around 1 year of age). Accidental nerve injury must be avoided by first making a l superficial incision to search for the finger nerve. The torn finger nerve and ligaments must be repaired. Although we cannot recommend this at this time, there are reports of no complications with percutaneous trigger thumb release in children. There is usually no recurrence after adequate release.