Children with various hand problems, including rare congenital anomalies, and surgeons with the expertise to correct them, can now connect thanks to a new clinic that opened Friday at Primary Children's Medical Center.

It's the first pediatric hand clinic in the Mountain West region."The clinic is a joint effort of the divisions of plastic and orthopedic surgery," said Dr. Graham D. Lister, chief of plastic surgery and director of microsurgery at the University of Utah Medical Center. "We will offer comprehensive diagnosis and treatment of a broad range of hand problems resulting from congenital anomalies, injuries, tumors, juvenile rheumatoid disease and cerebral palsy."

The clinic was conceived several years ago as a way to effectively pool resources to benefit both patients and physicians who'll have the advantage of being able to collaborate on the rare and complex hand problems among infants and children.

"Congenital anomalies of the extremities are so rare that when pediatricians see one in a patient it is often completely new to them, particularly if it is not one of the 13 anomalies that make up about 87 percent of the cases," Lister said. "But in Utah, we have a great deal of expertise to draw from. With this clinic, physicians will be able to provide their patients with the information and expertise they need almost immediately."

According to the specialist, congenital anomalies of the hand occur in one in 100,000 children, and microsurgery for the pediatric hand is available in only about 12 medical centers in the country.

Utah is one of the fortunate ones.

Last week, Lister performed Primary Children's first toe-to-hand transfer on 11-month-old Jessica Montgomery of Dallas. The microsurgery provides Jessica with the important use of the thumb, which is similar in structure to the toe.

In another recent procedure, he removed four extra digits one from each of Nicholas Watts' hands and feet.

Surgeons also replaced several of 15-year-old Brenda Rowbury's joints and fused the knuckles on her right hand to improve mobility. Brenda's juvenile arthritis has progressively prevented her from performing simple tasks like grasping an object or opening a car door.

Little Ethan Gonzales too has benefited from the expertise of a Utah surgeon participating in the clinic. Ethan was born without one of the bones in his forearm, and was missing his thumb and index finger.

Dr. Larry Leonard, another specialist in microsurgery, performed two operations on the tyke the first to straighten his wrist, which was bent toward his elbow. During a second operation, Leonard freed the joints in Ethan's middle and ring finger.

A third operation will be necessary for Leonard to create a thumb, making the hand much more functional.

"When working with the hand our first concern is making it more functional, and then to make it as aesthetically pleasing as possible," Lister said. "In the hand, function constitutes beauty."

In addition to the surgeons, occupational and physical therapists and a geneticist will be on hand for each clinic, to be held the first Friday of each month, beginning at 1 p.m.