Publication: Network meta-analysis of management of trigger thumb in children
Issued Date
2021-01-01
Resource Type
ISSN
14735865
1060152X
1060152X
Other identifier(s)
2-s2.0-85106885457
Rights
Mahidol University
Rights Holder(s)
SCOPUS
Bibliographic Citation
Journal of Pediatric Orthopaedics Part B. (2021), 351-357
Suggested Citation
Todsaporn Sirithiantong, Patarawan Woratanarat, Thira Woratanarat, Chanika Angsanuntsukh, Tanyawat Saisongcroh, Nattawut Unwanatham, Ammarin Thakkinstian Network meta-analysis of management of trigger thumb in children. Journal of Pediatric Orthopaedics Part B. (2021), 351-357. doi:10.1097/BPB.0000000000000809 Retrieved from: https://repository.li.mahidol.ac.th/handle/20.500.14594/78720
Research Projects
Organizational Units
Authors
Journal Issue
Thesis
Title
Network meta-analysis of management of trigger thumb in children
Other Contributor(s)
Abstract
To estimate and rank cure and recurrence rates between conservative and operative treatments for trigger thumb in children. A systematic review was conducted by searching PubMed and Scopus. Eligible criteria were comparative studies included non-syndromic trigger thumbs, aged up to 10 years, reported at least 20 thumbs and followed up at least 12 months. Two assessors independently extracted data and appraised for cure, recurrence rates among observation, stretching, splinting, open surgery, and percutaneous surgery. We assessed the risk of bias in non-randomized studies of interventions. A network meta-analysis, and probability of being the best outcomes were estimated with surface under the cumulative ranking curves (SUCRA). From 6853 searched articles, eight studies (799 children and 981 thumbs) were included. Mean age was 1.87-2.83 years and average followed up time was 1-5.7 years. Open surgery, percutaneous release, splinting, and stretching had higher cure rate than observation; pooled risk ratio (95% confidence interval) of 2.06 (1.53-2.78), 1.79 (1.26-2.53), 1.76 (1.30-2.36), and 1.37 (0.93-2.03), respectively. Percutaneous release increased risk of recurrence 3.29 times (1.42-7.60) when compared with open surgery. The best cure rates were open surgery (SUCRA = 95) followed by splint (SUCRA = 63.4), and percutaneous technique (SUCRA= 62.8). The highest recurrence rates were percutaneous (SUCRA = 97.3), and open surgery (SUCRA = 62.4). Splint is the most appropriate intervention for pediatric trigger thumb. After failed conservative methods, open surgery is considered for operative treatment. Level of evidence: Therapeutic study level II-III.