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

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.