4.11.2012

Trigger Thumb


So a few months ago when Maddie first started feeding herself snacks, I noticed that she was using the tip of her thumb and pointer finger to grab things with her left hand (the pincer grasp), but that she grabbed things in an odd way with her right hand (using the side of the knuckle on her thumb and the side of her pointer finger). I figured that she was just getting the hang of the pincer grasp and didn't think much of it.

Then last night after a very busy day, Maddie fell sound asleep in my arms. Amused by her complete exhaustion, I started playing around with her limp arms and hands. I noticed that although every muscle in her body was limp, her right thumb was stuck in a bent position. I gently pressed on it to see if it would go straight but it did not budge. I pushed harder and harder, until I was putting a lot of pressure on it and it still stayed bent. I also felt a bump at the base of her thumb. I wondered for a moment if she had dislocated it playing or if she broke it. But as I pressed she slept soundly, oblivious to any pain.


Concerned, I looked through my computer at all my photos and videos of Madeline and realized that in every single one her thumb was bent. I googled "baby's finger stuck in bent position" and found information about pediatric trigger thumb, (thumb is stuck in fixed, flexed position due being born with a tight fibrous band). I pushed up Maddie's nine month check up to get an expert opinion.  The pediatrician checked it out and made the diagnosis almost immediately.

While I am relieved that Maddie's thumb isn't broken or dislocated, I am still broken hearted for my sweet girl because she will most likely need surgery. While spontaneous recovery does happen, our Dr. said that it was rare in babies and children. So we will "wait and see" and massage her thumb daily to hopefully loosen the tendon naturally. The good news is that it shouldn't interfere with her development, though she may end up favoring her left hand and becoming left handed. She also may need to do therapy to correct the muscles in her right hand.

While I am sad that Madeline has to deal with trigger thumb and likely need surgery, I recognize how blessed we have been when it comes to Madeline's health and well being. Besides a minor case of the sniffles and eczema she has been a very healthy girl. I just feel so bad thinking that she may be in pain, that it may be holding her back, or that it may hold her back in the future. I also feel bad for not noticing it sooner!

If Madeline needs surgery it is a relatively easy procedure that has statistically very positive outcomes. It would be outpatient and she would wear a soft cast for a couple weeks. My main anxiety about surgery is the idea of having Madeline put under general anesthesia and dealing with a potentially traumatic experience at a young age. 

So please say a little prayer for our baby girl. We hope that she can recover from this without surgery.

UPDATE:
It's been a long time since that first diagnosis. Our pediatrician was very helpful and encouraged us to continue waiting it out and not do surgery when she was 1 year old. I am so glad we decided to wait it out. When Madeline was 17 months, her thumb spontaneously went straight! She is now 2 1/2 and it is still straight. She has been doing great with writing and with other fine motor skills. She does sometimes move her thumb around to where it sticks for a second and then she unsticks it herself by bending her thumb. It doesn't hurt her at all. Our pediatrician is not concerned and says she is doing great.

1 comment:

Ryan & Jamie said...

I am sorry to hear that your sweet girl has to deal with that. And that YOU do too. It's so hard when our babies aren't just perfectly healthy in every single way and part of their body. Even if it's something small, like the tip of a finger or thumb... or in Grace's case it was her clogged tear ducts. They're small things, but you want them to have everything in working order! I totally understand what you're feeling. Sending babies into surgery, especially with anesthesia, is not easy. But if it comes to that, she will do great!! And just think of all the extra cuddle time you'll get afterwards through the rest of that day. They are sweet moments you will cherish, I promise. :) Silver lining.