Pediatric Trigger Finger: Causes and Treatments

• Pediatric trigger finger can occur in young children. It is usually not obvious at birth but may begin to be noticed when the child is about 6 months to 2 years old.
• Observable symptoms include the child bending the finger in an unusual way, a clicking sound when moving the finger, or being unable to fully straighten the finger. It is most common in the thumb (trigger thumb), followed by the middle finger and ring finger.
• Trigger finger in young children resolves naturally in around 50-70% of cases, but in some cases, treatment such as finger manipulation, physical therapy or surgery may be necessary.

Trigger finger in young children may seem unlikely, but in fact it can be seen from the time a child begins to grasp objects. It is most common in the thumb (trigger thumb), followed by the middle finger and ring finger. If you notice that your child bends a finger abnormally or there is a clicking sound when moving the finger, it may be a sign of trigger finger that should be properly treated to avoid impacting the child’s development.

Trigger finger is a condition where the tendon sheath becomes thickened. The exact cause of this thickening is not clearly known, but it is believed to result from abnormal tissue development in that area starting from the fetal stage. It is not caused by parents handling the child’s fingers incorrectly or by any accident.

Symptoms of trigger finger are usually not obvious at birth but may begin to be noticed when the child is about 6 months to 2 years old, with the following characteristics:

• Finger locked in a bent position. The finger, especially the thumb, remains bent toward the palm all the time, cannot be straightened on its own, or can only be partially straightened.
• Catching when bending or straightening. When trying to bend or straighten the finger, the movement may be jerky, with a click or snapping sound.
• A nodule. A small lump may be felt at the base of the affected finger on the palm side, where the tendon catches.
• A lack of pain. In most cases, children do not feel pain even if the finger is locked or catching, but sometimes there may be slight discomfort when trying to straighten the finger.

In more than 50–70% of young children, trigger finger resolves naturally, especially between the ages of 1-2 years. Therefore, doctors usually recommend treatment starting from the least to the most invasive options, as follows:

1. Observation
   If the condition is not severe, the child has no pain, and the finger is not locked in a bent position all the time, the doctor may recommend close observation. Parents may also be taught simple exercises to do with their child to improve tendon movement.
   • Stretching/Physical therapy. Suitable for children aged up to 2 years. Parents can gently massage and stretch the base of the affected finger several times a day to stretch the tendon sheath and allow the tendon to move more smoothly. Parents should consult a doctor or physical therapist to learn the correct method.
2. Surgery
   Doctors may consider surgery if the child is 2-3 years old or older and the finger remains locked in a bent position all the time, or if the condition has lasted more than 6 months.
   • Surgical approach. This is a minor procedure that does not take long. The surgeon makes a small incision in the thickened tendon sheath to allow the tendon to move freely again. The surgery is very safe, and most children can use their finger normally within a few weeks after the procedure.

• First, do not worry too much. Trigger finger in young children is usually not dangerous and often resolves on its own.
• Watch for abnormal signs. If the finger becomes more bent, or there is swelling, redness or warmth, or the child cries a lot when the finger is touched, see a doctor immediately.
• Strictly follow the doctor’s instructions.
• Encourage development and support your child. Even with trigger finger, children can still do activities and learn according to their age. 

Trigger finger in young children is a condition that can be found from the stage when children start using their hands. Although it is often not severe and can resolve on its own, it can possibly affect the child’s hand function development in the long term. Recognizing the signs early and consulting a specialist will help your child receive proper and appropriate care.

1. Why does a child have bent fingers from birth, or what causes trigger finger?
   Answer: Trigger finger in children is a condition where the tendon sheath becomes thickened. The exact cause of this thickening is not clearly known, but it is believed to result from abnormal tissue development in that area starting from the fetal stage. It is not caused by parents handling the child’s fingers incorrectly or by any accident.
   Trigger finger can occur in young children. It is usually not obvious at birth but may begin to be noticed when the child is about 6 months to 2 years old.
2. How is surgery for trigger finger in children performed?
   Answer: 
   • Around 50-70% of trigger finger cases in young children resolve naturally, but in some cases treatment such as finger manipulation, physical therapy, or surgery may be necessary.
   • Surgery for trigger finger is considered if the child is 2–3 years old or above and the finger remains locked in a bent position all the time, or if the condition has lasted more than 6 months.
   • The surgical method is a quick and minor procedure. The surgeon makes a small incision in the thickened tendon sheath to allow the tendon to move freely again. This surgery is very safe, and most children can use their finger normally within a few weeks after the procedure.