Our Experts

L. Andrew Koman, MD

L. Andrew Koman, MD, specializes in pediatric orthopaedics and hand surgery, conducting translational research in hand and microsurgery, upper extremity vascular disorders and pediatric cerebral palsy. He collaborates with pharmaceutical, orthopaedic manufacturing and other industry partners to improve patient care and develops technologies for license to further that same goal.

About L. Andrew Koman

L. Andrew Koman, MD, earned his medical degree from Duke University School of Medicine in 1974 and completed additional postdoctoral training there, including an internship in pediatrics, residencies in general and orthopaedic surgery and a hand/microsurgery fellowship. He served on the faculty at Duke University for eighteen months before joining the orthopaedic surgery faculty at Wake Forest School of Medicine in 1981.

Koman’s research focuses primarily on two areas: microvascular physiology and pediatric cerebral palsy. He is a pioneer in the study and use of intramuscular injections of botulinum toxin to improve upper and lower extremity function of children with cerebral palsy. Through several multicenter clinical trials, he has shown the toxin injections as a safe, effective treatment strategy for spasticity associated with cerebral palsy, changing the way the disease is treated worldwide.

Other research efforts center on upper extremity vascular disorders and the control mechanisms involved in microcirculation. During his more than 40-year career, Koman has received multiple grants, including a grant from National Institutes of Health to examine microvascular control of patient upper extremities and treatments for cold sensitivity, blood clots, nerve repair, replantation and chronic pain. He developed the sympathectomy technique for Refractory Raynaud’s Syndrome that is the standard procedure for peripheral and periaterial sympathectomy used today. This unique approach encompasses the entire hand rather than the single digits.

Nationally recognized for excellence in research, he has received the American Academy of Orthopaedic Surgery’s Kappa Delta award and the Pediatric Orthopaedic Society of North America’s Huene Award. He has served as president of the Southern Orthopaedic Association, the Eastern Orthopaedic Association, the North Carolina Orthopaedic Association, the American Society of Surgery of the Hand and was the founder and first president of the North Carolina Society of Surgery of the Hand. He is editor-in-chief of the Journal of Surgical Orthopaedic Advances and has published four books and more than 200 articles and book chapters.

Koman works closely with pharmaceutical, orthopaedic manufacturing and other industry partners to create protocols, advance surgical techniques and further drug development. He is fascinated by the journey of scientific discovery and how ideas transform into mechanisms of care. He holds a patent in dose and localization of botulinum toxins in skin and muscle and developed an external fixator to correct deformities in upper and lower patient extremities. Most recently, he created a suture needle holder protective device for surgical procedures. Koman is also the chief medical officer for Keranetics, Inc., a company that develops treatment options for wound management, advanced wound healing and tissue regeneration.


L. Andrew Koman, MD, professor and chair of orthopaedic surgery at Wake Forest School of Medicine, specializes in:

  • Pediatric cerebral palsy
  • Spasticity management
  • Botulinum toxin injections
  • Upper extremity vascular disorders
  • Peripheral nerve repair
  • Pediatric orthopaedic surgery
  • Microsurgery
  • Chronic pain control
  • Regenerative medicine
  • Surgical device development