Individuals With Cerebral Palsy “CHArmed” By Specialized Program

Children and Adolescent Hand and Arm (CHArm) Center Helps with Function and Mobility

NEW YORK—June 10, 2008 

Fifteen-year-old Chris Gambro loves playing lacrosse, but because of his cerebral palsy he couldn’t fully use his right arm when playing. That all changed after Chris visited the Children and Adolescent Hand and Arm (CHArm) Center at New York’s Hospital for Special Surgery.

After an in-depth consultation, Chris underwent surgery that relaxed his elbow muscles and lengthened his wrist muscles as well as the muscles between his thumb and first finger. Months later, the young lacrosse player had a greater range of mobility in his right arm and the ability to grip the lacrosse stick with his right hand.

The Cerebral Palsy and Neurological Upper Extremity (CPNUE) Program at the CHArm Center focuses on the orthopedic needs of the upper extremities for people like Chris, who have cerebral palsy and other neurological disorders. Through in-depth assessments and surgical reconstruction, when indicated, problems related to extremity posturing, hygiene and functional limitations are addressed in the shoulder, elbow, hand, digits and thumb. Cerebral palsy (CP) is a group of motor problems and physical disorders related to brain injury or to problems with brain growth. CP causes uncontrolled reflex movements and muscle tightness that may affect a part, a side, or the entire body, with varying severity.

Prior to his surgery at Hospital for Special Surgery (HSS), Chris underwent extensive physical and occupational therapy in California, where the Gambro family previously resided. The therapy continued in New Jersey, where they currently live. It wasn’t until his third grade teacher, who also has cerebral palsy, recommended HSS that Chris’ parents began to consider surgery as an option.

The Gambro family met with Michelle G. Carlson, M.D., hand surgeon at HSS, founder of the CHArm Center, and designer of the CPNUE program. Dr. Carlson was the same surgeon who operated on Chris’s third grade teacher and is well known for her work in cerebral palsy and upper extremities.

“Chris’s function problems were mainly around his elbow and fingers,” said Dr. Carlson. “I was able to release the muscles around his elbow, which allowed his arm to be more relaxed and mobile.” Dr. Carlson also lengthened the muscles in Chris’s web space, the space between the thumb and first finger, to allow Chris to grip things, such as a lacrosse stick. “Overall, the surgery has increased Chris’s range of motion,” said Dr. Carlson, adding that, “Therapy after the surgery proved to be equally important in attaining the best results.”

“Dr. Carlson was very honest with me about what the surgery would do for me,” said Chris. “She said it wouldn’t be a miracle, but that I would see improvement.”

Since the surgery, both Chris and his mom, Joan, can see improvement. “I have more mobility in my arm,” says Chris. “I’m now able to throw and catch in lacrosse with both arms, and my playing has improved too.”

Aside from helping Chris become a better lacrosse player, the surgery allowed him to do everyday things like opening a book, carrying a plate and brushing his hair using his right arm.

Mrs. Gambro noticed Chris’s increased self-confidence. “He’s more comfortable with himself now. The folks at the CHArm Center really supported our family through this whole process. There was a seamless segue between surgery and physical therapy.”

Other Services Offered at the CHArm Center

The Cerebral Palsy Neurological Upper Extremity (CPNUE) Program is only one of several specialized services offered at the CHArm Center. Other surgical and nonsurgical treatments of hand and upper extremity conditions include: sports injuries; congenital disorders; juvenile rheumatoid arthritis; shoulder, elbow, hand and arm injuries; and hand and arm fractures. The CHArm Center is committed to improving community education about hand injuries in the pediatric and adolescent population through educational programs for athletic trainers, school-based healthcare workers and sports participants.

Visit the CHArm Center or call 1-888-CHArm40 (1-888-242-7640) to learn more.

About Hospital for Special Surgery
Founded in 1863, Hospital for Special Surgery (HSS) is a world leader in orthopedics, rheumatology and rehabilitation. HSS is nationally ranked No. 1 in orthopedics, No. 3 in rheumatology by U.S. News & World Report (2007), and has received Magnet Recognition for Excellence in Nursing Service from the American Nurses Credentialing Center. In the 2006 edition of HealthGrades' Hospital Quality in America Study, HSS received five-star ratings for clinical excellence in its specialties. A member of the NewYork-Presbyterian Healthcare System and an affiliate of Weill Medical College of Cornell University, HSS provides orthopedic and rheumatologic patient care at NewYork-Presbyterian Hospital at New York Weill Cornell Medical Center. All Hospital for Special Surgery medical staff are on the faculty of Weill Medical College of Cornell University. The hospital's research division is internationally recognized as a leader in the investigation of musculoskeletal and autoimmune diseases. Hospital for Special Surgery is located in New York City and online at

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