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Congenital limb anomalies, which involve malformations of the bones, muscles, joints, and soft tissues, present significant challenges for orthopedic interventions. These anomalies can range from limb deficiencies, such as amelia and phocomelia, to deformities like clubfoot, polydactyly, and syndactyly, each requiring tailored surgical approaches. Variations in musculoskeletal structures, including bone length, joint alignment, tendon attachment, and soft tissue integrity, complicate surgical planning and execution. For example, limb deficiencies may necessitate bone grafting or prosthetic interventions, while conditions like clubfoot require precise tendon lengthening or joint releases. In cases of syndactyly, tendon transfers and skin grafts may be needed for functional reconstruction. Early diagnosis and advanced imaging techniques are crucial for creating individualized treatment plans that address both functional and aesthetic concerns. Understanding these musculoskeletal variations is vital for orthopedic surgeons to optimize surgical outcomes and improve the quality of life for individuals with congenital limb anomalies