Hand and Microsurgery Program

The Children’s Orthopaedic Center at Children's Hospital Los Angeles provides state-of-the-art care for children with hand and upper extremity injuries and deformity. The dedicated team of specialists at the hospital's Hand Clinic work in tandem to treat kids with disorders that affect the hand, elbow and shoulder, with treament plans tailored specifically to their needs, which can include peripheral nerve surgery and bone and soft tissue reconstruction. 

One out of every 600 children is born with some minor or major difference in their hands, fingers or toes. With therapy or surgery, we can optimize the function and appearance of the hand and upper extremities. Surgeons and occupational therapists see patients together, developing the appropriate plan for each child.

Our orthopaedic physicians see more than 200 children each month and nearly 50 percent of patients in our pediatric hospital emergency room on a single night are hand or upper extremity related infections, fractures and other injuries. 

We treat childhood hand and upper extremity disorders such as:

• Amniotic band syndrome
• Brachial plexus palsy 
• Cerebral palsy
• Congenital hand anomalies
• Extra or missing fingers or thumbs
• Fractures

Children with rare and unusual diseases or problems with the bones, muscles, nerves, arteries or tendons of the hand and upper extremities are often seen by our pediatric orthapaedic specialists.

The Hand and Microsurgery Program works closely with the Neuromuscular Program to treat children with spasticity or palsy syndromes. The Children's Orthopaedic Center offers outreach programs to families to help integrate these exceptional children into schools, sports and community.

Congenital Conditions (present at birth)

• Camptodactyly - bent fingers (at the middle joint)
• Clinodactyly - crooked fingers (most commonly of the little fingers)
• Duplicate thumb - extra thumb
• Polydactyly - extra fingers
• Symbrachydactyly - shortened or absent fingers
• Syndactyly - webbing of the fingers
• Radial club hand - absence or shortening of structures on the radial (thumb) side of the hand or forearm
• Ulnar club hand - absence or shortening of structures on the ulnar (pinky) side of the hand or forearm

Traumatic Conditions (caused by an accident or an injury)

• Fractures (broken bones)
• Nerve Injuries
• Tendon Injuries

Other Pediatric Upper Extremity Conditions

• Brachial Plexus Injury - nerve injuries of the upper arm; can occur during birth, or an injury
• Cerebral Palsy - often results in muscle spasticity of the arms, hands