Paul Manske could make a thumb. He could make an arm, too. But he was known for his thumbs. Some children are born without thumbs. An estimated one in 600 children is born with a missing finger or other congenital hand abnormality. During a three to five hour operation, Dr. Manske could make a finger into a thumb for a child who had none. He changed the lives of thousands of children born with abnormalities. He helped untold thousands more through the hundreds of surgeons he trained as the former head of orthopedic surgery at Washington University School of Medicine. Dr. Paul R. Manske died April 20, 2011, at Barnes-Jewish Hospital. He was 72 and had lived in Clayton. Although he was diagnosed with lymphoma about a year ago, friends said he was able to perform surgery as recently as three months ago.