Shriners Hospitals for Children-Northern California’s Pediatric Hand and Upper Extremity fellowship offers an in-depth, hands-on exposure to all aspects of Pediatric Hand and Upper Extremity.
This fellowship lasts 6-12 months, and focuses on:
Anatomy of the Upper Limb
Hand Surgery Knowledge
Preparation for procedures
Decision-making as it applies to options, timing, psycho-social implications, and overall care of the child.
Interpersonal and Communication Skills
Prerequisite Training/Selection Criteria
Orthopaedic surgeons who have completed either a hand fellowship, or plastic surgeons who have completed a hand fellowship are eligible to apply. All qualified applicants are interviewed by each faculty member and ranked according to ability, interest, communication skills, motivation and integrity. The program does not discriminate with regard to sex, race, age, religion, color, national origin, disability, or any other applicable legally protected status.
Goals and Objectives for Training
Our program is one of 5 in the US; the faculty of these 5 programs are working together to develop a common curriculum for the Pediatric Hand and Upper Extremity. Currently neither of the fields of Pediatric Orthopaedic Surgery or Hand Surgery provide adequate experience in the care of children’s upper extremity problems, which include congenital malformations, trauma and post-traumatic deformities including burns, and neuromuscular conditions (brachial plexus birth palsy, spinal cord injury, and cerebral palsy).
We expect our Fellow to master the clinical and surgical skills for the management of the child with a complex upper limb problem, through exposure to all aspects of care: assessment and diagnosis (primarily in clinic); management (clinic and in-patient) and surgical planning and technical skill. We expect her to gain competency in teaching orthopaedic residents, pediatric orthopaedic fellows and hand fellows, and we expect her to participate in clinical research activities.
Fellowship training is based on the American Board of Medical Specialties (ABMS) / Accreditation Council for Graduate Medical Education (ACGME) Core Competencies (see below).
Program Certifications: No certificate currently exists for Pediatric Hand and Upper Extremity Surgery. Surgery of the Hand is a subspecialty approved by the ABMS and the American Board of Orthopaedic Surgery (ABOS).
Practice-Based Learning and Improvement
Fellows will begin the life-long process of personal continuing medical education and the application to the practice situation. Review of cares and outcomes will be done on a routine basis with the goal of improving patient care within one’s practice. This will include:
1. Preparation and participation in case discussions where decisions and ramifications of care are assessed.
2. Awareness of associated and relative morbidity of different treatment options.
3. Application of what is learned in conference setting to continually improve knowledge base and patient care.
VI. Systems Based Practice: Fellows should understand the continuum of care and their role in managing, not only the acute patient encounter, but also the resources needed to optimize care outcomes. This includes:
1. Integration of patient care into the local practice setting with respect to referral patterns, need for, and sequence of pre-operative assessments.
2. Awareness of the cost of care options being provided; and assumption of stewardship of resources in seeking the best options and value in patient care.
3. Adherence to “best practices’ per hospital
Michelle A. James, M.D.
Chief, Orthopaedic Surgery
Michelle Anne James, M.D., is Chief of Orthopaedic Surgery at Shriners Hospitals for Children — Northern California and Chief of Pediatric Orthopaedics in the Department of Orthopaedic Surgery at the University of California Davis Health System. Specializing in the treatment of children’s hand and arm conditions, including malformations and neuromuscular problems, Dr. James is a noted Pediatric Hand Surgeon. Dr. James serves on the Board of Directors of the American Board of Orthopedic Surgeons, The Perry Initiative, and Orthopaedics Overseas. She is Deputy Editor for Hand and Upper Extremity for the Journal of Bone and Joint Surgery. She is also Principal Investigator on two multi-center clinical research studies of hand function in children and has published numerous papers in peer-reviewed journals, as well as contributing to chapters to surgical textbooks. Dr. James has worked for Shriners Hospitals for Children – Northern California since 1989. She is a Clinical Professor of Orthopaedic Surgery at UC Davis and UC San Francisco. Her professional affiliations include the American Academy of Orthopaedic Surgeons, the American Society for Surgery of the Hand, the Pediatric Orthopaedic Society of North America, the American Orthopaedic Association, and the Ruth Jackson Society, for which she served as President in 2012. Dr. James organizes and attends a pediatric hand surgery service trip to a pediatric hospital in Managua, Nicaragua twice per year, and has served as a mentor for many pre-medical and medical students and orthopaedic surgery residents.Credentials
- Medical Degree, University of California, San Diego
- Residency, University of California, San Francisco, School of Medicine
- Fellowship in Hand Microsurgery, Indiana Hand Center
Lisa L. Lattanza, M.D.
Clinical Consultant, Department of Orthopedic Surgery
Lisa L. Lattanza, M.D.,is a Clinical Consultant in the Department of Orthopaedic Surgery for Shriners Hospitals for Children — Northern California. She also is Chief of Service in Elbow Reconstructive Surgery in the Department of Orthopedic Surgery at the University of California, San Francisco. Credentials
- Medical School, Medical College of Ohio, Toledo, Ohio
- Residency, University of Missouri, Columbia, Missouri, Orthopedic Surgery
- Fellowship, Columbia College of Physicians, New York, New York, Hand Surgery
- Fellowship, Roosevelt Hospital, New York, New York, Hand Surgery Medical School, Medical College of Ohio, Toledo, Ohio
Claire Manske, M.D.
Claire Manske, M.D., is a pediatric orthopaedic hand surgeon at Shriner’s Hospitals for Children—Northern California. She specializes in congenital, traumatic, and neuromuscular (cerebral palsy, spinal cord injury, and brachial plexus palsy) conditions of the hand and upper extremity, with a particular interest in brachial plexus birth palsy. Her research focuses on optimizing diagnosis, treatment, and outcomes of brachial plexus palsy and congenital hand differences. She has presented her research nationally and internationally and published scientific articles in multiple peer-reviewed medical journals. Credentials
- Medical Degree, Washington University School of Medicine in St Louis, Missouri
- Orthopaedic Surgery Residency, Washington University School of Medicine in St Louis, Missouri.
- Pediatric Orthopaedic Hand Surgery Fellowship, University of Washington in Seattle
- Pediatric Orthopaedic Hand Surgery Fellowship with Dr. Michelle A. James, Shriners Hospital for Children – Northern California
H. Relton McCarroll, Jr., M.D.
H. Relton McCarroll, Jr., M.D., is an Orthopaedic Surgeon at Shriners Hospitals for Children – Northern California and Clinical Professor of Orthopedic Surgery at the University of California, School of Medicine in San Francisco. In addition to his current medical duties, Dr. McCarroll assists and participates in the training of Orthopedic Residents in Hand and Upper Extremity Orthopedics during their rotations through Shriners Hospitals for Children – Northern California. He also assists and participates in the training of Fellows in Shoulder and Upper Extremity Orthopedics. Board certified by the American Board of Orthopedic Surgery, with an Added Qualification in Surgery of the Hand, Dr. McCarroll received his medical degree from Columbia University, College of Physicians and Surgeons. He completed a Fellowship in Hand Surgery with Dr. D.C. Riordan in New Orleans and has additional medical training at various Hand Centers in England, Scotland, and Europe. He is also a Licentiate for the California State Board of Medical Quality Assurance and the Missouri State Board of Medical Examiners.Dr. McCarroll’s professional affiliations include the American Academy of Orthopedic Surgeons, the American College of Surgeons, the American Society for Surgery of the Hand, and the British Society for Surgery of the Hand. He has presented and published widely on the subject of Orthopedics, particularly in hand and upper extremity issues.Credentials
- Medical School, Columbia University, College of Physicians and Surgeons, New York
- Residency, Barnes and Allied Hospitals in St. Louis, Missouri, Orthopedics
- Residency, Campbell Clinic Memphis, Tennessee, Orthopedic Surgery
- Residency, Shriners Hospitals for Crippled Children, St. Louis, Missouri, Orthopaedic Surgery
- Fellowship, Dr. D.C. Riordan, New Orleans, Louisiana, Hand Surgery
For more information, please contact:
Department of Orthopaedic Surgery
2425 Stockton Boulevard Sacramento, CA 95817
Phone: (916) 453-2049
Fax: (916) 453-2202