Anatomical variations of blood supply to the island flap in modified Bilhaut-Cloquet procedure for thumb duplication.

J Hand Surg Eur Vol · Aug 09 2026 · Recent

Kong C, Liu J, Zhang C, Zhang J, Tian X

Department of Plastic Surgery, Southwest Hospital, Third Military Medical University (Army Medical University), China

Hand & Upper Extremity

SUMMARY — THE REDUCTIONAmong 190 thumb duplication cases, the vascular pattern of the island flap in modified Bilhaut-Cloquet procedures predicted surgical success, with fine communicating branch anatomy giving 100% success.
Abstract, as published

INTRODUCTION: The aim of this study was to report the anatomical variations in the blood supply to the island flap harvested from the radial thumb in modified Bilhaut-Cloquet procedure for thumb duplication.

METHODS: A total of 190 patients with Wassel type II-IV thumb duplication underwent the modified Bilhaut-Cloquet procedure. The blood supply to the flap was assessed and anatomical patterns were recorded based on the relative calibres of the proper digital artery and communicating branches.

RESULTS: Three types of blood supply were identified: fine communicating branch type (n = 134), equal calibre type (n = 43) and coarse communicating branch type (n = 16). The coarse communicating branch type exhibited the lowest success rate, while the fine communicating branch type achieved a 100% success rate.

CONCLUSION: The blood supply patterns to the island flap is crucial for improving surgical outcomes and reducing complications in thumb duplication correction.

LEVEL OF EVIDENCE: IV.

Featured in the 2026-08-11 issue.

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