Trapezio-metacarpal arthritis. Trapezium excision and ligament reconstruction not including the LRTI arthroplasty

For trapeziometacarpal arthritis, trapezium excision and ligament reconstruction that is distinct from the ligament reconstruction tendon interposition (LRTI) arthroplasty has a distinct role. Emphasis is placed on the use of the abductor pollicis longus for tendon interposition and "suspensionplasty" for the arthritic thumb carpal metacarpal joint. The advantages of the abductor pollicis longus techniques as originally advocated by Thompson, and modified by Diao, are reviewed. The surgical technique for this procedure, clinical results and biomechanical cadaver analysis comparing abductor pollicis longus suspensionplasty done with two techniques, as they compare to the LRTI procedure, are included. The abductor pollicis longus suspensionplasty is an excellent treatment choice both for index procedures for carpometacarpal (CMC) thumb arthritis, and for salvage of the failed thumb CMC arthroplasty.