ABSTRACT
Introduction: Congenital trigger thumb is an uncommon anomaly of children. Its management is controversial, ranging fromobservation to extensive release.Aim: The aim of the study was to study the functional outcome of surgical management of the congenital trigger thumb in children.Materials and Methods: In this prospective study, 26 thumbs (21 pediatrics) underwent surgical release of the trigger thumb.Surgery was performed under general anesthesia with a tourniquet.Results: The prospective study demonstrated that pre-operative range of motion (ROM) averaged 36° loss of extension (range,0°–90°; standard deviation [SD], 22°); and post-operative ROM averaged 1° loss of extension (range, 0°–30°; SD, 7°) at 3 yearsfollow-up. There were no secondary surgeries. The children were being followed up for 3 years. All of them are found to havea good functional outcome and free of any complications until follow-up for 3 years.Conclusion: Congenital trigger thumb is a rare anomaly which is noticed by the parents around the age of 1½ years. Asconservative treatment invariably failed to give good results, all children are managed surgically with better cosmetic andfunctional results.
ABSTRACT
introduction: Clubfoot and its management have been the topic of keen interest to the orthopedics field ever since timeimmemorial and many techniques in the successful management of these have been advocated till date. This study discussesone such technique of management in children with Joshi’s external stabilization system (JESS) fixator.Aim: This study aims to evaluate the role of JESS in the management of neglected, resistant and relapsed congenital talipesequinovarus (CTEV), in the age group of 1–6 years.Materials and Methods: A total of 20 feet in 20 children underwent JESS fixation surgery at the Department of Orthopaedics,Government Rajaji Hospital, Madurai Medical College, from October 2015 to September 2018.Results: Four patients had excellent results, 12 patients had good results with an average score of 78, three patients had fairresults, and poor results in one patient. The average pre-operative Pirani score was 4.5 and post-operative score of 0.93 withP < 0.001 which was statistically significant. The average pre-operative Dimeglio score was 12 (Stage III) which statisticallyimproved post-operative (P < 0.001) to 5 (Stage 1).Conclusion: By controlled differential distraction using JESS apparatus, a painless, Pliable, plantigrade. The perfect sized andcosmetically acceptable foot has been obtained even in children 1 year–6 years. Controlled differential distraction using JESSfixator has got a definite role in the management of relapsed and neglected CTEV and it does not prevent the foot from beingtreated surgically at a later date if needed.