Introduction:
Congenital trigger thumb is an uncommon anomaly of children. Its management is controversial, ranging from observation to extensive surgical release. We report a case of delayed presentation of bilateral trigger thumb along with a brief review of past literature.
Case report:
A six year old girl presented with fixed flexion deformity of interphalangeal joints of both thumbs and Notta's nodules. It is diagnosed as trigger thumb and release of bilateral A1pulleys is done. But we found another constricting annular pulley just distal to A1. Only after splitting the distal pulley, we could get complete extension of interphalangeal joints. At two years follow-up, the child is free of complications.
Conclusion:
Splitting of A1 pulley alone may not be sufficient in few cases of trigger thumb which may require distal release too.