I will want to go on to assess the patient clinically with Hx, PE, Invx? Why is it important to check elbow function? How will you examine the patient with hypoplastic thumb? What investigations for radial club hand/ Thumb hypoplasia? Associated Syndromes Set for various conditions What is radial club hand? What gene? [same for hypoplastic thumb] How do you classify the Radial Club Hand? How do you classify the thumb hypoplasia deformity? How will you manage this child with Radial Club hand? When will you NOT operate [CONTRAINDICATIONS]? What are the surgical principles? What are the principles of Centralization? What are the principles of treating thumb hypoplasia? Complications of Centralization? What if recurrent? Salvage? - Do not miss the scars. THis means it is a RECURRENT radial club hand. May need salvage procedures