Background: The Bilhaut-Cloquet operation is a combined surgical
procedure for the treatment of a symmetric bifid thumb. Although this
procedure can obtain a normal-sized thumb with a stable interphalangeal joint,
it has limitations, such as the technical difficulty of combining all segments
of a duplicated thumb, possible later physeal growth arrest, joint stiffness,
and nail-plate deformity. We reviewed the results of our modification of this
procedure for the treatment of Wassel type-II and III polydactyly of the
Methods: Seven patients, two with type-II and five with type-III
polydactyly of the thumb, underwent the modified Bilhaut-Cloquet procedure and
were followed for an average of fifty-two months. Cosmetic and functional
assessments were made.
Results: All patients and their parents were satisfied with the
cosmetic and functional results. Compared with the preoperative motion, the
postoperative range of motion of the interphalangeal joint was preserved in
thumbs with type-III deformity and was increased in those with type-II
deformity. No nail deformity or growth arrest occurred, and remodeling and
hypertrophy of the distal phalanx occurred with time.
Conclusions: Our modification of the Bilhaut-Cloquet procedure for
the treatment of type-II and III thumb polydactyly is effective in preserving
interphalangeal joint motion, minimizing nail deformity, and preventing growth
Level of Evidence: Therapeutic Level IV. See Instructions
to Authors for a complete description of levels of evidence.