Abstract
The general considerations of overall care are examined in this article so that the contribution in the care team by the hand therapist is identified. An introduction to some understanding of the emotional response in the parents to the birth of a child with anomaly is presented, and based on this important first principle, some of the issues of care of the infant, support for the parents, possible conservative approaches, decision making, and the timing of surgery are briefly outlined. After considering the many issues involved in the general management of congenital anomaly, the second part of this article introduces the very specific classification system which exists to describe hand anomaly, and illustrates this by focusing in particularly on the classification for the thumb, with a basic outline of treatment for hypoplasia and aplasia of the thumb.
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