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Shriners Hospitals for Children — Lexington family information.

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Hand, arm and shoulder

Hand, arm and shoulder

Hand, arm and shoulder

Hand and finger deformities

There are many types of congenital finger and hand deformities that are treated by an orthopaedic surgeon who specializes in hand surgery. Some examples of deformities we treat are:

Cleft hand

This is a congenital condition in which one or more fingers are absent; however, the small finger is always present. Cosmetics and functionality are the major concerns with a cleft hand. Some children may have very mild limitations, while others may have significant issues. Treatment often includes occupational therapy, as well as surgical intervention.

Club hand

This is also known as radial club hand or radial dysplasia. This is a congenital condition in which the radius bone in the forearm is either malformed or absent. In some cases, the thumb can be small or absent as well. Treatment usually begins in infancy and often includes occupational therapy, as well as surgery.


This condition refers to being born with extra fingers and/or toes. This deformity occurs during the development of the fetus. Polydactyly is treated with surgery to remove the extra digits.


This is a condition in which the fingers/toes were not completely separated during development. Some forms of syndactyly are inherited, while some forms occur sporadically. Sometimes, the hand functions well without surgery. At other times, surgery is required to separate the fingers and deepen the space between the fingers.

Trigger finger

This is a common condition where a finger snaps or locks, causing dysfunction and pain. Trigger finger may be treated with splinting and a home exercise program. If this is not successful, surgery may be required to release the finger so it may be straightened.

Upper extremity conditions

Amniotic band syndrome

This is a rare syndrome caused when thin strands of tissue form inside the amniotic sac, tangling around the baby while still in the womb. Pressure from the strands can affect the way the baby grows. While most bands affect only the outer layers of soft tissue, tighter bands may go all the way to the bone. Treatment is individualized based on the child’s specific needs, depending on where and how deeply the amniotic bands affected development.

Brachial plexus injury (Erb's palsy)

The brachial plexus is a bundle of nerves located in the shoulder area. If these nerves are damaged during the birth process, there may be a loss of movement or weakness of the arm. The physician and occupational therapist will perform a thorough assessment to determine the best treatment plan. Treatment options vary, depending on the severity of the injury, but usually include range of motion exercises and massage therapy. Periodic evaluations are important to assess progress. Surgical intervention may be indicated in some cases.

Upper extremity fractures

This is a common injury in children. Common causes for upper extremity fractures are falls, sports injuries, as well as motor vehicle accidents. The fracture may occur anywhere along the shoulder, arm, elbow, wrist or hand. The emergency room is the usual initial contact for the patient, where the extremity will be stabilized. Following the initial treatment, the patient will be followed closely to monitor healing, pain management and functioning. Because each fracture is unique, the need for surgery will vary with each individual. Post injury therapy is extremely important to achieve optimal functionality.

Congenital limb deficiencies and amputations

This includes a variety of developmental disorders such as fibular deficiency, tibia deficiency, amniotic band syndrome or congenital amputation. A child may be born with a condition where the limb has a complete amputation or the child is born without a functional lower part of the arm/leg. A multidisciplinary team of surgeons, nurses, prosthetists and therapists evaluate and work with each child to create a solution that maximizes their individual function.