Objective To observe the improvement effect of surgical treatment on the functional recovery of patients with congenital thumb polydactyly (CTP) of different clinical classification. Methods Twenty patients with hand CTP admitted to our hospital from January 2017 to February 2023 were selected. All patients were classified according to the Wassel classification standard after admission, and the corresponding surgical treatment plan was selected according to the clinical classification. The operation time, hospitalization time and wound healing time of the children were recorded, and the postoperative functional recovery was evaluated. The Kawabata scale and quality of life scale were used to evaluate the thumb function and quality of life of the patients. The satisfaction of the family members of the patients with the shape and function of the affected finger was investigated by questionnaire, and the postoperative complications were followed up and recorded. Results There was no significant difference in operation time, hospitalization time and wound healing time between patients with different clinical classification (P>0.05). The excellent and good rate of clinical treatment was 95.00%. The range of motion, joint stability and angular deformity scores after operation were higher than those before operation, and the differences were statistically significant (P(P<0.05). The family members' satisfaction with the appearance and function of the hand was 95.00% and 100.00%, respectively. After 3 months of follow-up, the incidence of complications was 10.00% (2/20). Conclusion Wassel clinical classification can provide a reliable basis for the selection of surgical options for patients with hand CTP, improve the surgical effect, improve the prognosis of patients, and is conducive to the recovery of thumb function after surgery, which is worthy of clinical application.