Hand and upper extremity conditions occur in the shoulder, arm, elbow, wrist, hand and fingers. These conditions can be congenital (present-at-birth), neuromuscular (related to nerves and muscles), due traumatic or post trauma or related to sports participation. Depending on the condition, it can affect the bones, joints, muscles, tendons, ligaments or nerves in the upper body.

Our orthopedic hand and upper body specialists at Children’s Wisconsin treat all types of orthopedic conditions of the hand, arm and shoulder. These include sports-related injuries, general trauma and congenital (present-at-birth) differences. Some of the conditions we treat include:

• Amputations: Loss or removal of a body part such as a finger, hand or arm
• Broken bones (fractures): Broken bones of the collarbone, shoulder, elbow, forearm, hand and fingers
• Contractures or spasticity: Shortening of a muscle or tendon, while spasticity is a motor disorder that causes the muscle to become stiff and limit motion — both can occur in the upper body and may need treatment to restore motion
• Ganglion cysts: Fluid filled cyst that can develop along the tendons or joints of the wrist or hand
• Gymnast wrist: Irritation of the growth plate in the wrist, often appears in young athletes with repetitive weight bearing through their hands, wrist and arms
• Joint instability: Instability of the shoulder, elbow and fingers (including “jammed” fingers)
• Nailbed injuries: Damage to the tissue underneath the fingernail
• OCD of the elbow: When a small piece of bone and cartilage in a part of the elbow joint separates from the bone around it — this condition can be mild, moderate or severe
• Sprains & strains: Sprain is a stretching or tearing of a ligament and strain is pulling or tearing a muscle or tendon in the shoulder, elbow, hand or fingers
• Triangular fibrocartilage complex (TFCC) tear: The TFCC is made up of the ligaments, tendons and cartilage that support the wrist. The TFCC can tear during a fall or in sports that require repetitive wrist movement, such as tennis, gymnastics and football
• Trigger finger: Thumb or another finger gets stuck in a bent position, affecting the movement and function of a child’s hand
• Ulnar Collateral Ligament (UCL) injury: Injury to the ligament on the inside of your elbow that can vary from mild to severe — a severe UCL injury is a tear in the UCL, which may require surgical repair known as a “Tommy John surgery”
• Ulnar variance: Can be a neutral, positive or negative difference in the length of the ulna compared to the radius in the wrist

Our experts use a combination of history, physical exam and imaging tests for diagnosis of congenital defects of the hand, arm and shoulder. These tests include:

• Computed tomography scan (CT scan): Uses a combination of X-rays and computer technology to produce detailed, cross-sectional images of the body, including the bones, muscles, fat and organs
• Magnetic resonance imaging (MRI): Uses a combination of large magnets, radio frequencies and a computer to produce detailed images of organs and structures within the body
• X-Ray: Uses invisible electromagnetic energy beams to produce images of internal tissues, bones and organs onto film
• EMG

Our compassionate, comprehensive care will support your child’s health and healing as they recover from an injury or work through a new or ongoing diagnosis. Your child’s treatment could include:

• Surgery:  In some cases, surgery might be required to repair a badly torn ligament or tendon. Our highly skilled pediatric orthopedic surgeon will surgically repair tendons and soft tissue in a precise and delicate manner to preserve your child’s movement and function in the future.
• Hand therapy:  Our certified pediatric hand therapists will help your child maximize functional use of their hand/arm.  It is a critical part of the postsurgical and nonsurgical process to promote healing, increase range of motion and maximize functional use of your child’s hand/arm. Our certified hand therapist offers serial casting, custom splinting, paraffin wax treatments, scar massage and more.
• Bracing and casting: Orthopedic specialists at Children’s Wisconsin’s stabilize broken bones with innovative casting techniques to ensure the best outcomes for growing bones. Fun colors and glitter? We’ve got that covered, too.

Expert pediatric care: Children’s Wisconsin offers the only comprehensive pediatric hand and upper extremity program in the state. Our program provides multidisciplinary care to infants, children, adolescents, and young adults with a wide variety of conditions in the shoulder, arm, elbow, wrist, and hand. Small, growing hands need specialized care. A child’s hand is intricate, requiring a highly skilled pediatric hand surgeon to surgically repair the bones, tendons and soft tissue in a precise and delicate manner to ensure the highest level of functionality. Kids are not just little adults, and require unique, individualized care for their developing little bodies. Our doctors are pediatric hand experts specializes 100% in kids and teens.