Upper limbs are always involved. Abnormalities may be unilateral or bilateral and asymmetric and may involve the radial, carpal, and thenar bones. Left-sided defects are often more severe than those on the right. The most prevalent findings are malformations or fusions of the carpal bones. Thumbs are commonly affected and can be triphalangeal, hypoplastic, or completely absent. Abnormalities range from minor (clinodactyly of the fingers, limited supination of the forearms, and sloping shoulders) to severe (reduction deformities, including phocomelia [10%] and ectromelia). Other defects observed include posteriorly and laterally protuberant medial epicondyles of the humerus, hypoplastic clavicles, shortened radii, and ulnar hypoplasia. In this case, the bifid thumb with duplication of the distal phalanx on the right hand is an unusual finding.