Thumb deformities with only soft tissue and no bone may involve both upper extremities, with the left side being more severe. Variants or defects of the forearm, wrist and radial bones are the most common. The radial carpal bones may be delayed due to ossification, so that the base of the first metacarpal bone is close to the midline and juxtaposed with other metacarpal bones, and the pisiform bone may disappear, and the thumb loses its function of opposing the palm because it is at the same level as the other limbs, and the thumb variant is a characteristic change of the sign of the disease, which is often semi-dislocated, syndactyly, triple-jointed thumb, the last joint curved to the ulnar side, bifurcated, and short, or lacks of or the thumb only has soft tissues and no bones. Soft tissue without bone. What are the examination methods for the thumb with only soft tissue and no bone? 1.Family survey: family survey for cases with both congenital heart disease such as atrial septal defect and hypoplasia and defects of the upper limbs, especially the thumb. In one family, there were 9 cases in 4 generations. 2. Echocardiography, cardiac catheterization, electrocardiogram, X-rays, and dye dilution curves were performed to determine the type of congenital heart disease. 3, Skeletal x-ray and chromosomal examination. Heart failure may occur, complicated by infective endocarditis. Loss of para-palpebral function may be accompanied by high palpebral arches, cleft palate, short stature, facial hypoplasia, facial hemangiomas, unequal pupil sizes on both sides, occlusion of the external auditory canal, and malformations of the gastrointestinal and genitourinary tracts.