What is trigger thumb?
Trigger thumb is a condition in young children where the thumb becomes locked in a bent position and cannot easily straighten. It typically affects children between 1 and 5 years of age and is not usually present at birth.
Why does it happen?
The cause is not completely understood, but it may be due to a mismatch in size between the flexor tendon of the thumb and the sheath surrounding it. This mismatch can cause the tendon to catch or get stuck, limiting smooth thumb movement.
How does it present?
Your child may:
- Hold the thumb in a bent (flexed) position at the tip (interphalangeal joint).
- Be unable to give a “thumbs up.”
- Have a small bump at the base of the thumb on the palm side (called Notta’s nodule).
- Occasionally be able to straighten the thumb with a “clicking” sound.
- Rarely complain of pain, but some discomfort may occur when trying to extend the thumb.
About 25% of cases are bilateral, though not always at the same time.
How is it treated?
Observation
- In children under 2 years of age, the condition may resolve on its own.
Conservative treatment
- Passive stretching exercises at home.
- A thumb splint/orthosis may be tried, but compliance is often difficult.
Surgical treatment
- Considered if the deformity persists after age 2–3, is fixed, or does not improve after 6 months of observation.
- A short day surgery under general anesthesia.
- The sheath around the tendon is released through a small incision at the base of the thumb.
- Surgery allows immediate correction and restores normal thumb movement.
- No physiotherapy is needed after surgery.
Additional information
- Trigger thumb is different from trigger finger in children and adults.
- Diagnosis is clinical, based on the child’s history and physical examination. No imaging is needed.
- Steroid injections are not recommended in children.
Consult your doctor if your child…
- Complains of pain or avoids using their hand
- The trigger thumb persists beyond age 2.
- Other fingers (not just the thumb) are catching, locking, or stiff.
Download the information sheet for trigger thumb
Click on the image below to download the printable information sheet for trigger thumb.
