About the Hand and Arm Disorders Program

The Hand and Arm Disorders Program at Children's Hospital of Philadelphia (CHOP) is the region's largest multidisciplinary center providing evaluation, treatment and long-term follow up to children with a hand or arm anomaly, injury or tumor.

Each year, our board-certified orthopaedic and plastic surgeons perform more than 1,000 procedures on infants, children and teens with hand or arm conditions, including:

  • Syndactyly: Fingers that are webbed or jointed together; this is one of the most common hand disorders.
  • Polydactyly: Extra fingers or thumb duplication; this is one of the most common hand disorders.
  • Hypoplastic digits: Missing or underdeveloped fingers.
  • Macrodactyly: Abnormally large fingers.
  • Camptodactyly: A flexed finger (bent at the middle joint) that cannot straighten. Most often affects the small finger. Seen in newborns, but may develop in young adolescents. 
  • Clinodactyly: An abnormally bent or curved finger.
  • Cleft hand: A split hand that is usually V-shaped and may also include missing fingers.
  • Radioulnar synostosis: An abnormal fusion of the bones in the forearm.
  • Radial club hand: The radius bone in the forearm is missing or didn't form properly during prenatal development.
  • Trigger finger: A common cause of bent thumbs in pre-school age children that is effectively cured by a surgery, not caused by injury.
  • Ulnar club hand: The ulna forearm bone wasn't formed properly during prenatal development, leading to an abnormally bent wrist.
  • Madelung deformity: An abnormally aligned wrist.
  • Erb's Palsy: A form of paralysis caused by trauma to the upper brachial plexus in the spinal cord, usually during childbirth.
  • Limb defects: A condition where part of the hand or arm fails to form properly during prenatal development.
  • Injuries such as fractures, dislocations, tendon injuries, nerve injuries, burns and replantation of limbs (reattachment).
  • Tumors such as bone tumors, endochondroma, osteochondroma, sarcoma, skin cancer, hemangioma, ganglion cyst and soft tissue tumor.

Customized treatment for your child

Surgeons and clinical staff from two core divisions — orthopaedics and plastic surgery — create a custom treatment plan for each child with a hand or arm disorder. By joining forces early in your child’s diagnosis, our team can work to enhance both the functionality and appearance of your child’s affected hand or arm.

Because of the interconnectedness of the hand, wrist and forearm, treatment for disorders in these areas require clinicians to examine how possible treatment will affect other parts of the child’s anatomy. The goal of any treatment is to optimize your child’s function and quality of life.

Our multidisciplinary team of surgeons, radiologists, advanced practice nurses, physical therapists, occupational therapists and others consider all possible treatment options for children with hand and arm disorders. If surgery is needed, our team works with pediatric anesthesiologists and pain specialists to make your child’s surgery as safe and comfortable as possible.

Some of the surgical procedures available at CHOP include:

  • Reconstructive surgery
    • Surgically removing extra fingers (polydactyly)
    • Separating webbed fingers (syndactyly)
    • Thumb reconstruction — a toe transfer or pollicization procedure (moving the index finger to become a thumb) to treat a hypoplastic (missing) thumb
    • Replantation surgery — to reattach a digit
  • Arthroscopy — minimally invasive surgery to make delicate repairs
  • Tenolysis — surgically releasing tendons to treat conditions like trigger finger
  • Surgery to treat fractures of fingers, hand, wrist, arm and elbow
  • Tendon or muscle repair or transfer
  • Nerve grafting

Through our program, your child has access to the full range of pediatric subspecialties and expertise from orthopedics, plastic surgery, genetics, radiology, oncology, neurosurgery, rehabilitation and more to determine your child’s diagnosis, treatment and follow up.

We offer a full spectrum of diagnostic testing including magnetic resonance imaging (MRI), MRI reconstruction, computed tomography (CT) scans, X-rays, bone scans and more. With advanced testing modalities and expert clinicians, CHOP's Hand and Arm team can identify the specifics of your child’s hand or arm disorder and establish a customized, comprehensive treatment plan, including surgery if needed.

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Would you like a second surgical opinion from a CHOP expert?

Our referral nurse navigator can give your family timely access to world-renowned pediatric orthopaedic surgeons in every specialty.

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Why Choose the Hand and Arm Program

Our program is led by a medical staff with nearly 75 years of combined experience treating hand and arm conditions.