Pediatric Surgery for Hands and Upper Extremities
What makes Cook Children's pediatric orthopedic care unique? The depth and breadth of our expertise. Each year, our team delivers high quality care to more than 1,000 patients from across Texas and the surrounding region. Our orthopedic surgeons have expertise caring for children with rare congenital, vascular and neuromuscular conditions. The team works closely with families and referring physicians to identify and implement individualized plans that provide the best care and outcomes for each patient. We treat a full range of upper extremity conditions from the shoulder to the hand in patients from infancy to young adulthood. Treatment options include focused hand therapy, splinting, medical and surgical intervention.
As a referring physician, you can be assured that we will provide the most advanced care available, tailored to your patient's needs. Our goal is to maximize each child's ability to use their hands and upper extremities as they grow and develop. By working closely with families and referring physicians, we can develop individualized recommendations to achieve this goal.
Why choose our Hand and Upper Extremity Surgery Program?
When you refer a patient to our team, you'll find:
- Expertise: Our medical director, Pamela Sherman, M.D., is a board certified orthopedic hand surgeon with over two decades of experience treating upper extremity conditions including soft tissue, bone reconstruction and microsurgical procedures.
- Comprehensive care across specialties for complex conditions: We care for many children with complex congenital, neuromuscular and vascular conditions. For patients with additional medical needs, we collaborate with Cook Children's specialists in cardiology, hematology and oncology, interventional radiology, neurosurgery and pain management. At Cook Children's, we work together as one team for the overall health of the child. Conditions we treat and procedures we perform include:
- Absent digits or thumb
- Amniotic band
- Bifid thumb
- Cerebral palsy reconstruction
- Enchondroma and osteochondroma
- Madelung's deformity
- Microsurgical procedures and reconstructive surgery
- Radial longitudinal deficiencies
- Ulnar longitudinal deficiencies
- Personalized care: We combine the latest surgical techniques with pre- and post-operative rehabilitation therapy to provide patients with the best outcomes. We develop individualized treatment plans based on each patient's stage of growth and unique needs.
Partnering with you for pediatric upper extremity and hand care
From the moment you contact us, you'll appreciate the commitment of our Hand and Upper Extremity Surgery team. We believe that the best patient outcomes start with building strong working relationships with all caregivers, including you.
When you refer a patient to our program:
- You can monitor your patient's progress through our physician portal.
- A member of our Global Health Care Services team will be assigned to you for any immediate needs you have.
- Your patient is sent home knowing that you will also be informed of any follow-up care that may be needed.
Advanced tools to measure function and identify treatment
Our hand therapists use advanced technology to evaluate a cerebral palsy patient's movement as they perform daily tasks. This has been supported by a grant from our foundation to provide this evaluation to our patients so as not to compete with other therapy services they may be receiving. With this information, we can make an accurate diagnosis and develop a treatment plan to improve each patient's hand and arm function.
In a notable case, Dr. Sherman and the Cook Children's Hand Therapy coordinator, Cara Smith, evaluated the hand function of a patient named Katie with hemiplegic cerebral palsy. After this detailed assessment and discussion of the results, Katie and her family were able to more comfortably make the decision for surgical intervention of her upper extremity. Read more about Katie's story and the work of Dr. Sherman's interdisciplinary team.
Research and education to advance care
Our current research projects include:
- Prospective study to analyze surgical outcomes for cerebral palsy patients in collaboration with faculty at Texas Christian University
- Research to explore benefits of robotic gloves for cerebral palsy patients in collaboration with faculty at University of North Texas
- Study to explore new treatments for congenital conditions affecting the hands and fingers
Because we see a large volume of rare, complex pediatric conditions, we provide a unique learning experience for orthopedics trainees. We're proud to help advance care by training orthopedics residents and fellows from institutions ranging from Texas to Massachusetts.
Hand and Upper Extremity Surgery team at Cook Children's
Meet pediatric orthopedist Pamela Sherman, M.D.
Board certified in orthopedic/hand surgery, Dr. Sherman is one of the leading physicians of the orthopedic surgery program here at Cook Children's. Recognized internationally for her surgical skills, she has helped many patients gain or return to independence with use of their hands and upper extremities.
Additional team members
Cara Smith, PT, CHT, MSHA
Hand Therapy program coordinator
Alex Hussey, OTR, MOT
Hand Therapy program coordinator
Child Life specialist
At Cook Children's, we provide care that addresses improving and restoring function and movement in the upper extremities of children throughout their growth and development with the goal of improving independence into early adulthood. Each team member plays a specific and crucial role:
- Orthopedic hand surgeon with over two decades of experience caring for children with hand and upper extremity differences
- Physical and occupational therapists from our Hand Therapy program with expertise in rehabilitation therapy for a wide range of conditions
- Orthotists and prosthetists with expertise creating customized bracing, splints and prosthetics to improve movement and function
- Registered nurse and physician assistant who provide care at every stage of treatment
- Child Life specialist who helps children learn what to expect and provide comfort throughout therapy
- Social worker who offers resources to ease the time families spend at Cook Children's and provides assistance when it's time to return home
Collaborative care from a team of experts in hand and upper extremity care
Our Hand and Upper Extremity Surgery Program is part of Cook Children's Orthopedic Surgery. We have comprehensive clinics that allow patients to be seen across the many specialties required for their conditions. This is incredibly helpful for our patients that travel great distances for their care. We use a team approach with a collaborative effort with pediatric orthopedic colleagues in cases with both upper and lower extremity involvement. A focus of care is combining procedures within orthopedics or with other disciplines across the system whenever possible for surgical intervention. By using this approach, infants and children potentially undergo fewer trips to the operating room, placing less stress on them and their families.
Learn more about the upper extremity and lower extremity conditions we treat.
For patients with complex medical needs, we also coordinate care with specialists in:
- Hematology and Oncology
- Interventional Radiology
- Pain Management
Working together is in our DNA
It takes more than medicine and research to ensure that patients reach their goals, it also takes compassionate collaboration.
Our team of pediatric orthopedic surgeons and hand therapists works with you, your patient and the family to provide the best care. We offer infants, children and teens the most advanced care for complex conditions and injuries affecting the hands and upper extremities available today, to give them the best future.
Designations and recognition
When you refer a patient to Cook Children’s Hand and Upper Extremity Surgery Program, you can trust that you're choosing a team with the expertise, resources and commitment to provide the best care possible.
The Magnet® designation is considered the international gold standard of nursing excellence. Cook Children's Medical Center is the first pediatric hospital in North Texas, and the 10th in the world, to receive this prestigious designation four consecutive times.
Cook Children's is recognized as a Top Children's Hospital nationally by The Leapfrog Group. This award highlights our widely recognized achievements in patient safety and quality.
Coming from outside of Texas?
Our team in Global Health Services supports families who travel to Cook Children's for medical care from across the country and around the world.
Our concierge service is here to help with every detail. We work with families to:
- Schedule appointments
- Plan travel
- Find accommodations
- Offer financial counseling and insurance approvals
- Arrange translation services
Please contact our Global Health Services care coordinator if you need help with out-of-state or international referrals at: