Objective To investigate the clinical characteristics， personalized treatment strategies， and clinical outcomes of congenital clasped thumb. Methods From January 2010 to January 2025， a total of 40 patients with congenital clasped thumb were treated. The patients were classified according to the Tsuyuguchi classification system：6 cases of type I，22 cases of type Ⅱ， and 12 cases of type Ⅲ. Based on the classification， individualized surgical interventions and treatment protocols were implemented. For type I injury， conservative management involving orthosis application was implemented for infants under one year of age， and surgical treatment was performed for patients who failed conservative treatment. For type Ⅱ and Ⅲ injuries， personalized surgical approaches were employed. These procedures included reconstruction of extensor function， restoration of abduction capacity， expansion of the constricted first web space， and management of the deep head of the flexor pollicis brevis along with the transverse head of the adductor pollicis. Results Postoperative follow-up was conducted for all 40 patients， ranging from 12 to 96 months （mean 26.3 months）. Therapeutic efficacy was evaluated using the Gilbert assessment criteria. The overall excellent-to-good rate was 80% （32/40）. Specifically， type I thumbs achieved an excellent-togood rate of 83.3% （5/6）， type Ⅱ thumbs 82.8% （18/22）， and type Ⅲ thumbs 75% （9/12）. Conclusion Patients in this cohort exhibited satisfactory post-treatment thumb mobility and high treatment safety. Personalized treatment based on the clinical characteristics of patients can obtain satisfactory clinical efficacy， which is worthy of promotion and reference.

Congenital clasped thumb, Clinical characteristics, Personalized treatment