Team Approach: The Care of Children with Hand and Upper Limb Differences

Abstract

» Pediatric hand and upper limb differences include a wide range of conditions that may be genetic, part of a syndrome, or arise from birth trauma or an unknown cause.» Because of the variety of conditions and complexity of care requiring professionals from multiple disciplines, the Pediatric Hand Team is similar in purpose to the coordinated multidisciplinary care provided by Craniofacial Panels for children with craniofacial anomalies. Pediatric hand surgeons are trained to lead and coordinate the care of children with these differences, and the Pediatric Hand Team includes occupational and/or certified hand therapists, child life specialists, geneticists and genetic counselors, prosthetists and orthotists, pediatric physical medicine and rehabilitation physicians, pediatric orthopaedic surgeons, pediatric anesthesiologists, and social workers and psychologists. The Team must also have access to pediatric imaging, including ultrasound and magnetic resonance imaging.» Treatment of hand differences may include observation, splinting/bracing, therapy, reconstructive surgery, or a combination of these, and indications vary with development, age, associated conditions, and child and family preference. Children who have challenges coping with the stigma of their difference may benefit from programs such as Hand Camp and the Lucky Fin Project.» Multiple online and print resources are available to support the Pediatric Hand Team and the child's family and other caregivers.» A well-coordinated team-based approach meets the physical and psychosocial needs of the child with hand and upper limb differences from birth to adulthood.