Pediatric Hand and Peripheral Nerve Surgery

What is Pediatric Hand and Peripheral Nerve Surgery?

When your patients suffer a traumatic hand or wrist injury, chances are that they are being treated by the Pediatric and Congenital Hand Surgery Service in the Department of Plastic Surgery at Children’s Health℠.

Our Pediatric and Congenital Hand Surgery Service accepts referrals for traumatic hand injuries evaluated at outside clinics and hospital emergency departments.

The hand surgeons, Jonathan Cheng, M.D., Jennifer Kargel, M.D., and Purushottam Nagarkar, M.D. are full-time academic hand fellowship-trained surgeons with a strong commitment to patient care and service to the greater community. Both surgeons are specialized in hand and upper extremity care.

Our philosophy is to treat every hand condition, whether traumatic or congenital, as an extension of the patient as a whole. Our aim is to provide comprehensive restoration of form and function while accounting for the patient's daily activities and overall well-being.

Camila was born with VACTERL association, a rare disorder that affected her esophagus, ear, and her right arm and hand. Jonathan Cheng, M.D., Chief of Hand Surgery in the Congenital and Pediatric Hand Surgery Program at Children's Health, repaired her thumb hypoplasia by removing her thumb, which had no bones or tendons connecting it to the rest of her hand, and replacing it with her index finger. Watch the video below to see her results.

Pediatric Hand and Peripheral Nerve Surgery Doctors and Providers

Frequently Asked Questions

  • What do we treat?

    Our Brachial Plexus and Peripheral Nerve Multidisciplinary Team offers contemporary diagnosis and treatment of traumatic and birth-related brachial plexus injuries and reconstruction for facial nerve palsy patients.

    The team is composed of specialists in hand surgery, microsurgery, peripheral nerve reconstruction, physical medicine and rehabilitation, neurology, neurotology, pain management, and occupational and hand therapy.

    Our service provides expertise in peripheral nerve care, brachial plexus reconstruction and facial nerve/facial palsy reconstruction.

    In addition to treating hand trauma, including injured fingertips, tendons, nerves, and fractures, the hand surgeons take full care of the hand and upper extremity including congenital hand differences, sports injuries, and tetraplegia and cerebral palsy.

    We also perform comprehensive care of congenital hand differences, including polydactyly, syndactyly, duplicate thumb, radial club hand, amniotic band, and hypoplastic or absent thumb among other conditions.

    Careful evaluation of function, adaptation, and daily needs is performed through long-term follow up over the course of the child's development and growth. A comprehensive range of splinting and therapy options is available through our dedicated pediatric certified hand therapists.

    Sports Injuries

    Sports injuries require a careful balance of adequate time for healing, exploration of contemporary surgical options, and minimized time for return to sports participation. Our hand fellowship-trained surgeons offer optimized return to function while keeping the child's developed and future health in mind.

    Central Nervous System Disorders

    Central nervous system disorders, such as tetraplegia and cerebral palsy, can result in significant derangement of upper extremity function. Our primary responsibility in these cases is to unlock the child's precious, underutilized, residual function by borrowing from healthy muscle-tendon units to reconstruct crucial hand and upper extremity functions.

    We favor a multidisciplinary approach by working in conjunction with pediatric board-certified neurologists and PM&R specialists. This approach allows us to address overlying problems of spasticity, mobility, positioning, cognition, and nutrition.