gms | German Medical Science

Objectives/Interrogation: Isolated congenital trigger thumb and trigger finger is well known in literature and has a developed treatment algorithm. Non-operative treatment in congenital trigger thumb has good clinical outcome in comparison to trigger finger. However, bilateral symmetrical congenital trigger thumb and finger is extremely rare and roles in treatment remains elusive.

Methods: We described a 2-year-old child presented with fixed thumb interphalangeal joint and triggering of middle finger both hands symmetrically. The patient was diagnosed with bilateral symmetrical congenital trigger thumb and trigger middle fingers. The symptoms of the left hand resolved non-operatively with physiotherapy but the pathology on the right hand required surgery. The A1 pulley was released in the right thumb and right middle finger. Subsequent release of the A3 pulley and ulnar head flexor digitorumsuperficalis of the middle finger was resected. The outcomes were good post-operatively and the patient and parents were satisfied with the treatment.

Results and Conclusions: Bilateral trigger finger in addition to trigger thumb is very rare and can be treated both non-operatively and surgically. The left hand of this patient received physiotherapy treatment and surgical treatment on his right. Both the symptoms on his right and left hand resolved with return to full function. There is more to explore on the possibilities of non-operative roles in treating bilateral trigger fingers and trigger thumb.