Ideally, all surgery is undertaken in one stage. Most authorities will plan to do this between the ages of 9 months to 2 years. Earlier is potentially better given that the prehensile patterns of the hand are set within the first year. However, this must be balanced against the more difficult definition of parts in the smaller hands and the risks of general anaesthetic. If thumb hypoplasia is present in association with radial dysplasia, surgery for the latter is carried out first at approximately six months beforehand.
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