Delicate make up of the hand calls for expert care • Long Beach Post

The human hand is made up of 27 bones and three major nerves that make it possible for people to do every day things. That intricacy requires expert care when an injury in the hand occurs. This is especially true when a hand injury happens in a child or teen.


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Because a child’s bones are smaller and still growing, they will look very different than adult bones. Pediatric hand surgeons are experts in treating kids with conditions affecting the hand, wrist, arm and shoulder using surgical and non-surgical techniques, and are the best choice for treating injuries and deformities in the still developing hand.

With the addition of pediatric hand and upper extremity surgeon Anna Acosta, M.D., the Orthopedic Center at MemorialCare Miller Children’s & Women’s Hospital Long Beach has expanded to include advanced techniques for the most complex hand and arm surgeries.

With fellowships in both pediatric orthopedics and orthopedic hand and upper extremity surgery, Dr. Anna Acosta specializes in treating congenital and acquired hand and upper limb conditions, deformities and injuries. She uses advanced surgical techniques to restore hand function and correct hand and limb deformity and deficiency.

Since the hand is such a delicate balance of working parts, even minor abnormalities or injuries may cause a significant decrease in hand function or changes in appearance. The goal with treatment is to create the best functional and cosmetic results for each child.

In partnership with the plastic surgeons at Miller Children’s & Women’s, Dr. Acosta specializes in reconstructive microsurgery to repair intricate structures, such as blood vessels, nerves and tendons less than a few millimeters in diameter using specialized operating microscopes and precision instrumentation.

Microsurgery is a tool used to perform specific procedures including transfer of tissue from one part of the body to another (free tissue transfer), reattachment of severed parts (replantation) and composite tissue transplantation.

Using these advanced techniques, Dr. Acosta is able to reconstruct congenital hand defects, such as polydactyly (extra finger), thumb hypoplasia (small thumbs), syndactyly (fused or webbed fingers), radial longitudinal dysplasia (radial club hand) or symbrachydactyly (underdeveloped hand/fingers).

“Babies with radial longitudinal dysplasia (radial club hand) are often born without the normal amount of bones in their forearms and hands,” says Dr. Acosta. “Many times they have an absent or non-functional thumb. In these cases, we’re able to create a thumb for them by taking the index finger and moving it into thumb position, giving the child better function and dexterity in their hand.”

This is just one example of the many intricate reconstructions in which Dr. Acosta specializes.

Knowing treatment doesn’t end with surgery, Dr. Acosta partners with the Miller Children’s & Women’s hand therapists, who work with patients to facilitate improved function of the hand or arm.

“What I like most about this specialty is that there is a very delicate and creative nature to it,” says Dr. Acosta. “For many patients with congenital hand deformities, we are able to take the hand they were born with and add to it or alter what they have to improve the function of their hand. These kids never fail to amaze me. Most of them function at a high capacity and are able to do everything that their peers can do.”

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