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CMC arthritis: Resection Arthroplasty

- Discussion:
    - historically has yeilded good results in relieving pain;
    - disadvantages:
           - thumb shortening and subsidence, weakness of pinch, and decreased ability to adduct the thumb;

- Operative Technique:
    - dorsal longitudinal incision centered over CMC joint;
          - incision is curved volarly at the base of thenar eminence;
    - superficial branches of the radial nerve are identified;
    - abductor pollicis longus is transected 1.5 cm proximal to its insertion;
    - EPB is retracted dorsally;
    - longitudinal incision is made in CMC capsule, exposing the trapezium;
    - reflect thenar muscles distally off their insertion onto scaphoid and trapezium;
    - divide oblique ligaments (anterior and posterior) on ulnar side of metacarpal;
    - remove the trapezium;
    - interposition may consist of rolled up palmaris longus or gel foam;
    - abductor pollicis longus is shortened 1 cm and repaired

Treatment of trapeziometacarpal arthritis: Results of resection arthroplasty.

Stabilized resection arthroplasty by an anterior approach in trapeziometacarpal arthritis: results and surgical technique.

The results of excision of the trapezium.  

Excision of the trapezium in osteoarthritis of the first carpometcarpal joint.  

Trapezial space height measurement after trapeziectomy: A comparison of the use of standard and stress radiographs

Excision of the trapezium for osteoarthritis of the trapeziometacarpal joint: a study of the benefit of ligament reconstruction or tendon interposition.

Five- to 18-Year Follow-Up for Treatment of Trapezoimetacarpal Osteoarthritis: A Prospective Comparison of Excision, Tendon Interposition, and Ligament Reconstruction and Tendon Interposition.