Hand/Upper Extremity Surgery Clinic

The Hand and Upper Extremity Surgery Clinic at the Alfred I. duPont Hospital for Children provides care for children with disorders, deformities and disabilities involving the hand, wrist, elbow and shoulder. These problems may affect multiple sites and may involve the bones, muscles, tendons, nerves or blood vessels. Special consideration needs to be given to each of the aforementioned anatomic elements in order to provide the best treatment with the fewest complications. The nature of the disorder also needs to be considered. These problems may be present at birth (congenital), or develop later in life (acquired). They may be caused by an accident or injury (traumatic), or may be associated with other medical problems (part of a syndrome). At times these problems can be quite complex such as when a child has obstetrical brachial plexus birth palsy. Special training and expertise are required in order to offer the best available treatment for problems of such complexity.

Treatment of upper extremity problems covers a wide scope. The nature of the problem as well as the individual needs of the child need to be considered. The possibilities range from observation, to casting, to surgical intervention. A team approach is necessary in order to ensure the best care for the child. Often other medical specialists are consulted along with specialized therapists who help with the care and rehabilitation of the child.

Nemours physicians are specially-trained and are dedicated to providing the highest level of pediatric care to children. The Hand and Upper Extremity Surgery Clinic is staffed by orthopedic surgeons who have received further specialty training in hand, upper extremity, and microvascular surgery. The clinic uses the most innovative and up-to-date techniques available. The clinics physicians also recognize the importance of the parents role in the care and healing process of the child. The division is dedicated to increasing communication and building a strong doctor-parent partnership so that both the patient and the family are active participants in the decision making process. Nemours physicians follow their patients and therefore see the effects of their treatment, both surgical and nonsurgical, from childhood, through adolescence and into adulthood. They are committed to assisting with a childs complete growth and development.

Services Available:

• Hand and upper extremity surgery
• Occupational therapy
• Physical therapy
• Casting
• Observation

Typical Diagnoses/Problems:

• Syndactaly (joining of fingers)
• Polydactyly (extra fingers)
• Thumb hypoplasia (small and weak thumb)
• Radial club hand (absence of radial sided hand and forearm structures)
• Ulnar club hand (absence of ulnar side hand and forearm structures)
• Brachial plexus injuries/obstetrical palsies(nerve injuries of the arm usually suffered during birth)
• Congenital radial head dislocation (dislocation of elbow bone causing decreased motion)
• Cerebral palsy (spastic contractures of upper extremity)
• Symbrachydactyly (short and absent fingers)
• Thumb duplication (extra thumb digit)
• Keinbochs disease (collapse of bone in wrist)
• Pediatric fractures and malunions (acute broken bones and reconstruction of fractures that have healed out of alignment)