Hand and Microsurgery Program

The Division of Plastic and Maxillofacial Surgery at Children's Hospital Los Angeles has a long and proud history of providing state-of-the-art microsurgical care for children with congenital, acquired, and traumatic hand and upper extremity deformities.

Treatment and Care

In close coordination with our occupational therapy team, a treatment plan is tailored for each child and may include soft tissue, bone, vascular, and peripheral nerve reconstruction incorporating cutting-edge microsurgical techniques. 

Our Team

The Hand and Microsurgery Program provides a comprehensive team of uniquely trained physicians with several years of experience in the treatment of hand and upper extremity injuries and deformities.

  • Plastic and reconstructive surgeons
  • Occupational therapists
  • Clinical nurses
  • Physician assistants

Commonly Treated Conditions

A. Congenital hand differences

  • Amniotic band syndrome: constriction ring syndrome
  • Arthrogryposis: hand joint contractures
  • Camptodactyly: bent finger
  • Cleft hand: split hand 
  • Clinodactyly: crooked finger
  • Macrodactyly: large fingers
  • Madelung deformity: bent wrist
  • Polydactyly: extra thumb, extra pinky
  • Radial club hand: absent or small radius
  • Symbrachydactyly: short / small hand
  • Syndactyly: webbed hand
  • Thumb hypoplasia: small or absent thumb

B. Acquired upper extremity problems

  • Brachial plexus palsy: birth-related, obstetric, neonatal paralysis of the upper extremity
  • Burns of the upper extremity: scar contractures, joint contractures, open wounds
  • Cerebral palsy: upper extremity spasticity or quadriplegia from birth
  • Tumors of the upper extremity: ganglion cyst, bone tumors (enchondroma), nerve tumors (schwannoma), other masses
  • Trigger finger or trigger thumb

C. Traumatic upper extremity

  • Hand and wrist injuries: arteries, veins, nerves, tendons, bone fractures, joint dislocations, skin wounds
  • Partial or complete thumb or finger amputations: partial or complete absence of a thumb or finger

D. Peripheral nerve

  • Lower extremity paralysis: foot drop
  • Upper extremity paralysis or weakness

E. Microsurgery

  • Free flap coverage of wounds/defects
  • Free functional muscle transfer: Transplanting muscles to allow arm or leg movement for paralysis/palsy

Before and After Photos

The success of hand and upper-extremity surgeries can be dramatic. Here, you can view before-and-after photos of children who've had surgery to correct some of the conditions we commonly treat.