Tuesday, November 3, 2009
Congenital Trigger Thumb -or- My Child Can't Straighten her Thumbs
We noticed that my daughter (4 year old) had thumbs that didn't completely straighten a year or two ago. She really can not straighten them past what you see in the above picture. That's pretty much her "thumbs up." We thought at first that is was just a cute deformity and did not feel the need to pursue the issue. It wasn't until this year when my daughter started experiencing pain in one of her thumbs that we started to get concerned.
The pain didn't seem to have a real impetus. My daughter would be playing out of my sight and then she'd come to me crying and holding her thumb. I'd ask her what happened, and she wasn't sure. She had just used her thumb in such a way that it caused pain. The pain didn't usually go away right away. Sometimes it was just for 5 or 10 minutes, and once it took a whole hour. The pain was intense enough that she never allowed me to touch it, but it did go away on it's own, probably because she got distracted enough for whatever was out of wack to move back to the right place.
I started looking for answers by asking a nurse at my daughter's well-child visit. She looked at my daughter's thumbs and said that she was probably just really double jointed. That made very little sense to me. If it was normal, why was she having pain? That's when I tried to look it up online. I know doctors hate it when people try to self-diagnose using the internet, but I've had a lot of luck with it and I don't seem to have a lot of luck with doctors. It's not always easy to self-diagnose when you don't even know what terminology to use. I searched using terms like: child's thumb won't straighten, bent thumbs... and finally I stumbled across this website which had a picture of a child's thumb that looked a lot like my daughter's. It also named the problem: Trigger Thumb. So, I started looking up more information on trigger thumb. While my daughter's case didn't seem to fit all the criteria of a classic case, she did fit enough of it for me to want to take her to another doctor.
So, next we saw my daughter's pediatrician. She agreed with me that something was wrong, but she'd never seen this before, so she instructed me to see a pediatric specialist out of Denver. I asked her about trigger thumb. She said that we could use that as the working diagnosis, but she wanted to have the specialist give me an official one.
Today we drove to see the specialist. It took him no time at all to diagnose it, and sure enough, it's congenital trigger thumb. It normally resolves itself in most cases by the time the child is 4 or 5, but after that, outpatient surgery is usually necessary. My lucky daughter gets to have surgery on both thumbs. This means 3 weeks in casts too. Lucky me.
Here's some helpful website about the surgery and what it entails: http://www.handuniversity.com/topics.asp?Topic_ID=28
I'm writing about this because there isn't a lot online in the way of personal stories about it. Since congenital trigger thumb occurs in 2% of hand problems in children, it is not completely unheard of, but not completely common either.
To read the post about the surgery, click here.
To read a later post about preparing for the surgery, click here.