Thumb deformities with only soft tissue and no bone may involve the upper extremities bilaterally, with the left side being more severe. Variants or deformities of the forearm, wrist and radial skeleton are the most common, and the radial carpal bone may be delayed due to ossification, so that the base of the first metacarpal bone is close to the midline, juxtaposed with other metacarpal bones, and the interphalangeal area may disappear, and the thumb loses the function of the opposite palm because the thumb is at the same level as the other limbs. Thumb variants are the characteristic changes in the signs of the disease, which are often semi-dislocated, syndactyly, triple-jointed thumb, the last joint curved to the ulnar side, bifurcated, and short, or the thumb is missing only The thumb may be short or absent, or there may be only soft tissue and no bone. Hand-heart malformation syndrome is cardiac-limb syndrome, also known as Holt-Oram syndrome, atrio-digital syndrome, upper extremity cardiovascular syndrome, familial heart and upper extremity defects, atrio-digital dysplasia, atrio-digital dysplasia, and atrio-digital dysplasia syndrome. atrio-digital dysplasia syndrome. It is an autosomal dominant disease, characterized by cardiovascular malformations and skeletal malformations. It is an autosomal dominant disease with a family history of cardiovascular malformations and skeletal malformations. Embryological factors The skeletal malformations in this syndrome occur in the upper limbs on an embryological basis, and the occurrence of upper limb buds and the main differentiation process of the primitive cardiovascular system begin in the fourth week of the embryo and are completed within two to three weeks. Therefore, it is possible that the upper limb and the heart are simultaneously affected by certain factors and undergo mutations. According to Gegenbaur’s primitive wing theory, the ulna and its vicinity corresponds to the backbone of the primitive fin line, and the radius is one of the other four collateral lines, which occurs before the ulna and then tends to disappear, so that the radial skeleton is more likely to be involved. The lower extremities are not involved because they differentiate later than the upper extremities. This may help to explain why the radial skeleton is more likely to be involved in this syndrome. Genetic factors It is generally believed that this syndrome is autosomal dominant, but there are some single cases reported. Only a few people reported that the patient’s 16th pair of chromosomes have small variations, and the majority of people proved that the nuclei of the patient’s cells are normal. In the family of this syndrome, all those with congenital heart disease are accompanied by varying degrees of upper limb deformity, while those with upper limb deformity may not have congenital heart disease, but there is no difference in the heritability of the two to the offspring, so they are regarded as the patients with this syndrome, the chances of their offspring developing the disease is about 50%. 3.Drugs Influence Taking antiepileptic drugs within one month of pregnancy can lead to fetal morbidity.