ECRL-strip platy for metacarpal base fixation after excision of the trapezium

Excision of the trapezium is always followed by instability and proximal migration of the first metacarpal base. In the present report, a modification of a previously suggested technique of metacarpal fixation is presented. The base is trapped between the APL- and FCR-tendons by means of a strip from the ECRL-tendon. This technique was applied in 44 thumbs with trapezial arthrosis. Stability and mobility were restored in all thumbs and the results as to strength and freedom from pain were successful in 80%. The suggested procedure is simple both technically and in regard to post-operative care and is particularly suitable in older patients.