Monday, December 28, 2009

My Daughter's Trigger Thumb Surgery


For insurance reasons, we decided to go ahead and get my daughter's trigger thumb surgery done before the end of the year. We scheduled her surgery for Dec 23 at the Denver Children's Hospital. Yes, makes me sound like an uncaring parent to subject my child to a surgery that would require both her hands in casts two days before Christmas... but that's just how it all worked out.

Surgery check in time was at 8 am. Since we live far enough away from Denver, we booked a hotel so we could attempt to get a good night's rest the day before. I don't like to hold too much back from my children when they are directly involved. So I tried to prepare her for what was coming. My daughter knew that she was having surgery the next day. I told her they would put a funny mask on her face that would make her tired and fall asleep and when she woke up, her thumbs would be fixed. She knew that she would have casts on them too. I didn't want to leave any surprises. So, naturally, the night be before the surgery she had a hard time getting to sleep. But we survived it.

Due to fasting constraints, morning meant no food or drink for the little gal. Off to the hospital. Everything went smoothly, from check in to discharge. My little one exhibited no tantrums (yippee!), though she was a bit nervous. I'd like to think that this was because we had tried to prepare her. But, I never know if my attempts to help actually help. The actual surgery was very fast, maybe 30-40 minutes. But there was some recovery time afterward, which, for my daughter, only took about an hour and a half. We were out of the hospital by 1:30 PM. All the nurses and doctors were very nice and helpful, to whom we are grateful.

Even though the casts are quite pretty, my daughter wanted them off before we even left the hospital. But after a bit of explaining about how her thumbs needed to heal for 2-3 weeks, and then she would get them off, and she was okay with that.

Since then, my daughter has enjoyed the extra attention she gets from me, because I have to help her go to the bathroom, eat, and get dressed, among other things. She also really likes how I let her use a straw at meal time so she can at least drink on her own. Many of her Christmas presents she can not properly play with, so they'll get new life when our sweetie gets her casts off.

The chances of trigger thumb recurring while our daughter is a child are slim, the doctor said, but when she becomes an adult, she'll want to be careful about overusing her thumbs... for example: texting and video gaming. All the more reason to limit that sort of activity since I don't think it's all that enriching anyway!

To read the initial post about this, click here.
To read about cast removal, click here.

24 comments:

  1. Thank you for posting your experience. Please tell us how your daughter does. Last night I discovered my daughter cannot straighten her thumb. I think it has been like that for a while (based on photos) and we just didn't notice. I believe it will be confirmed as trigger thumb. She doesn't have pain but the thumb is totally locked. Were the doctors concerned about permanent stiff joint from lack of movement? Did they discuss/try splints before surgery? The wait to see a specialist will probably be at least 2 months for us.

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  2. The nurse I saw wasn't concerned at all. That's what motivated me to look for answers. When we saw her pediatrician, she didn't know what it was, but wanted us to see a specialist. The specialist told us that it's not a life-threatening or emergency situation, as distressing as it is to the parents. (But, it did seem to hinder my daughter's development. She hasn't been able to use scissors very well and using a computer mouse is uncomfortable. I will see if she shows much improvement in these areas in the coming weeks.) They say that if the trigger thumb is going to resolve itself, it will do so by the time the child is four or five. Because my daughter's thumbs were locked, splints wasn't an option. We're actually going to get her casts removed today. I'll post an update of our experience.

    Something you can do to check the thumb on your own: There is usually a little knob at the inside base of the trigger thumb. You can feel it go up and down as the thumb moves. That's all the specialist did to diagnose it.

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  3. My son is scheduled for trigger thumb surgery on both thumbs this coming Monday. How is your daughter doing now that it has been a number of months since her surgery? I have a feeling it'll be harder on us as parents than on him...they're just little troopers!

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  4. Hi! It's been 6+ months since my daughter's surgery. Can't believe it. She is doing just fine. Her right thumb healed with no problems... and her left thumb would have too except that she has a separate issue with that thumb that is complicating things. She has loose ligaments on her thumb so she has had to have therapy with that thumb to help her to be able to have full range of motion with it. She can't bend it at a 90 degree angle. (Not a huge deal.) The therapy is over now. They really couldn't do much. They suspect that she will grow out of it. So now we watch and wait. But, she can use both thumbs just fine and has no pain.

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  5. My daughter is going for surgery for one thumb Monday. I hope that she does well. Thank you for sharing your story. It is very comforting for me.

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  6. Kiana, I'm sure things will go well for your daughter. My best to you as well.

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  7. My 4.5 yr old daughter showed us her "drunk" thumb last month. We confirmed that she could not straighten the thumb out but was not in any pain so we had a good laugh. I mentioned it today at her check up, the nurse practitioner knew exactly what it was "trigger thumb" and would refer us to a orthopedic specialist. They called with an appointment for tomorrow. Now I was worried! Since her thumb is locked and has a nodule at the base, I am figuring the ortho Dr. will recommend surgery. Although I am hoping she will be one of the 63% that spontaneously corrects itself! It is much easier to look up the condition when you have a name for it, couldn't find much under "drunk thumb"! thanks for sharing

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  8. Triterra,
    Now, "drunk thumb"... that's a new one on me. Funny. If your daughter ends up with surgery, it's really not as bad as it sounds. I actually have a second daughter with trigger thumb. She's two now and I think I'll have her get surgery in a year. It being the second time I go through this, it seems less daunting.

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  9. Hi, my daughter had a surgery on her trigger thumbs. Thank god, it went fine. She didn't have a cast though, she only had badages. I noticed that your daughter has casts around her thumbs. I wonder if not having a cast would hurt her recovering. Two days after her surgery she was able to play, but here and there she would complain that there is pain, especially the first day after her surgery. Did u have to give your daughter any pain meds? If you did gave her some pain meds. to daughter, how long did u give it to her??? I did sometimes when she complained that there's pain. It's been a week, and my daughter still has her cast on,
    she is schedule in two weeks to see the Dr. who did her surgery. I hope that after her recovery everything goes well. I'm happy to hear that your daughter is doing well.

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  10. Hi Anonymous, I have heard that some children don't have casts after the surgery and use their thumbs right away. I guess it's a matter of preference of the surgeon. I do remember that after my daughter's casts were removed, because she hadn't used her thumbs for so long, we really had to coax her to use her thumbs. We only gave her the pain medication for a bit, until she stopped complaining about it. I remember that we threw the rest away, so I don't think she used it for more than a couple of days.

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  11. My daughter had her surgery about a year ago when she was 3 years old. She did not have a cast but there were enough bandages that she couldn't use her thumb. She was playing almost normally within a couple of hours. She was annoyed with the bandage and wanted it removed. Otherwise, she was fine. She hates taking medicine and didn't want any pain medication. I figured when it hurt enough, she would change her mind. She never did use the pain medication. When the bandage came off, she still used it a bit differently since she had adapted how she did things due to the trigger thumb. She could use it normally though and was so excited and proud she could straighten it. Today I cannot see the scar and she uses it completely normally.

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  12. Kiana,
    Thanks for sharing your daughter's experience with everyone. I think others will find it useful to know how she has recovered. I have another daughter with trigger thumb who will be having surgery in the next year. Since I'm in a different part of the country now, she'll have different surgeon and it will be interesting to see how her experience compares to that of my first daughter's. I'll certainly write about it when that time comes.

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  13. Hi thank you sooo much for sharing this! My son has trigger thumb on both hands. I saw it when he was 3 months old on the left hand and by 1 he had it on the right.... we had seen an Orthoped and he said come back when he was 3. ( Which he will be in a month.) I thought maybe they would work themselves out if we had therapy but they didn't. I had a Dr. look at it and said that it wasn't necessary to get it done now it wasnt't that bad. But they are bent all the time but it isn't painful to touch. But as a mother you feel bad that your child can't use their fingers correctly..... and now my husband is completely against surgery since the dr said their is a risk...but I think I want a 2nd opinion...... Sometimes it does hurt him though it he falls on them. ( And he says too, sometimes when we stretch them.) Reading your article has really helped me! I am going to show it to my husband! :) My son has had therapy for 2 yrs and still hasn't helped. I feel that he needs it and it should be done so that they don't contract. I am not sure what to do....Do you have any suggestions?

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  14. Hi Mandy,
    As a mom, I feel your predicament. You want to do what is best for your child, and it's hard to know what is. For us, surgery was the best option. Here's why, as my daughter got older (she was 4) and tried to learn new things, like using scissors or using the mouse on a computer, she struggled. (Bend your thumb and try using scissors or a mouse to get a feel for how difficult it is.) To make up for her triggering thumb, my daughter started to hyper-extend her thumb, making her tendons loose and long (not good, it required therapy after the surgery). You wouldn't think such a thing would matter, a bent thumb.

    Your doctor is right in that the surgery isn't necessary since trigger thumb is not a life-threatening condition. But, for my daughter, it was hindering her development.

    If I could do it again (and I can since I have another daughter with trigger thumbs that are also locked in the bent position) I'd have had her get the surgery sooner. My first daughter was 4.5 years old when she had the surgery. She had to learn the right way to use her thumbs over the wrong way that she had started using them (those ages between 3-5 are pretty big in learning fine motor skills). My second daughter will be turning three in about 6 months, and I think we'll schedule her surgery soon after. We'll see if it makes a difference. Hard to know.

    Sounds like you have kept on top of your son's condition and I'm sure that you'll know what direction to take as you continue to look into your options.

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  15. Thanks for sharing your story!! My daughter is 3.5 and she has 2 trigger pinkies, which apparently is not as common as the thumbs. We saw the surgeon today (as a follow up from over a year ago) and he recommends surgery so that it doesn't cause issues with development. They are scheduling surgery 6-8 months in advance so I'm hoping things will change before then, but this definitely makes me feel better. Thanks :)

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  16. My son will be 8 next week and he has trigger thumb on both hands. It doesn't seem to bother him and he never talks about them. He can pop them up and they will lock there and then pop them back down. I didn't realize there were options for this. It doesn't hurt him though...so I'm not sure if we should go the surgery rout? We'll see what the specialist says...

    Janelle

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    1. Yup, you are right, the specialist will be able to guide you best. I'm glad that your son hasn't been hampered by them at all. Take care!

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  17. Hello and thank you for sharing your experience. I noticed it when my son was one and half, the doctor said that he need a surgeon so now his 2,5 and will get it soon, we don't have the day yet. How is your daughter doing ? And did the second one have her surgeon ? Do you think that is better after their third birthday ? Because we might have our appointment before his. Thanks again apologies for my english as I am a French speaker.

    Munalpa

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    1. Hi! I'm glad you found my experience helpful. I have to apologize for my English too... Because that's all I can decently speak! I hope that joke doesn't get lost in translation. Anyway, your English is fine. Both my daughters are doing very well. They use their thumbs well and I can't even see so much as a scar on their little hands. They each had different surgeons since we lived in different places at the time of each surgery. I was happy with the outcome for both girls. Really, I think in anytime in between 18 months and 3 years is good a good time for the surgery, but really it doesn't matter when. Adults get it too. I just found that it was easier to care for a smaller child after surgery than for an older one. I hope it all goes well for you and your family!

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  18. As others have said, Thank You for posting your experience! We are in the process of scheduling surgery for my son who is 2 and has had both his thumbs locked/bent since birth. Your posts have helped me to know what to expect and some of the different options available (I like the idea of a hard cast instead of soft for my accident prone, overly energetic son). I think its amazing to see/read about how common this is - our doctor had never seen or heard of it. Thank you again!

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  19. Hi Humdrum Hero! Thank you so much for sharing your experience; it definitely helps to have another mother who has "been there & done that" to bounce questions off of or to share experiences with. I hear a lot about children who have "trigger thumbs" but not a lot in regards to children who experience the locking up of other fingers. My 8 year-old daughter has been experiencing "trigger middle fingers" on both hands for a few years now. We tried the splint technique but since she is so active...she just could not keep it on. Over this last year she began complaining about her left middle finger locking up more frequently & becoming painful. We took her to see the Orthopedist & of course he recommended surgery. He did say that the drawback of removing the sheath (which is getting caught up on the inflamed tendon) is that it will weaken the fingers as they won't have the stability of the sheath. I know that this is the case with this type of surgery on any finger, but I was wondering if there were any parents out there who are dealing with "trigger finger" in other fingers other than the thumb & what they are experiencing or how surgery & recovery went for their child? Thank you in advance for any info you may have.

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    1. Good question. I've only read about children having trigger fingers, but perhaps someone will read this comment and reply.

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  20. Hi, my daughter has just had her surgery yesterday, she 28 months, she is not at all phased about it, on asking her if she is sore she says no and on asking if she can feel her hands she says no. They are strapped up like little paws with bandages from tips to shoulders for infection. I was wondering if your daughter or anyone else had a pain free no feeling of hands that didn't phase their little ones. She is due for follow up in 10 days time. Will she start and feel it a bit later on? Thanks for any advice I've been following this wonderful blog since we found she was to have surgery. Best wishes G.

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    1. My girls didn't take the pain meds after the ones from surgery wore off, and didn't complain about pain, so I would say that you daughter has good company. ;) Perhaps after the bandages come off your little one might complain about pain, but that's likely because she just hasn't moved her thumb(s) in a while. But it should only take a few days before your daughter starts using them like normal. Hope all goes Well!

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