Objective: To develop the Bilhaut-Cloquet procedure according to the complication and take the review to analyze the results postoperation. Methods: Develop a modified Bilhaut-Cloquet procedure in hypoplasia of the duplicated thumbs as follows: A new nail reconstruct technique includes side incision and comprehensively considers the nail plate, nail lunula, and nail fold reconstruction, a bone reconstruction of intact joint function. From January 2010 to April 2014, 39 thumbs of 36 cases acquired more than 1-year follow-up. All cases were hypoplastic and had nail width less than 80% of that on the nonaffected side or less than 130% of that on the index. Results: According to the Tada scoring system, results were excellent in 30 thumbs, good in 8 thumbs, poor in 1 thumb. According to Wang-Gao scoring system, nail appearance was excellent in 32 thumbs, good in 7 thumbs. Conclusions: The nail deformity is inevitable according to our technique, but the sore of nail appearance and the function is satisfying. The modified Bilhaut-Cloquet should be recommended as the first-line therapy in hypoplasia of duplicated thumbs.
