Suspensionplasty for basal joint arthritis: why and how

Abductor pollicis longus suspensionplasty is a simple, effective treatment alternative forbasal joint arthritis. Use of a suspensionplasty technique acknowledges our current understanding of forces involved during pinch and grip, as well as the role of normal ligamentous anatomy. The primary rationale for performing suspensionplasty revolves around resisting the sagittal plane collapse that will occur when the thumb is loaded during pinch. In the absence of a volar-based suspension of the metacarpal, cantilever bending forces and axial force transmission will result in the dissipation of force along the thumb lever arm, and ultimately longitudinal collapse. Maximal grip and pinch strength require suspensionplasty, which can be performed using a variety of techniques. The author's current technique for suspensionplasty is described.