New Transfer for Correction of Thumb Metacarpophalangeal Hyperextension in Cases With Associated Surgery for Basal Thumb Osteoarthritis (Transfer of the Volar Half of the Abductor Pollicis Brevis)

Abstract

We present a new technique for the correction of thumb metacarpophalangeal joint hyperextension in patients with concomitant basal thumb osteoarthritis. For consistent result with trapeciometacarpal arthroplasty both pathologies should be treated at the same time. Cases with passively reducible metacarpophlangeal joint (without osteoarthritis or severe medial instability). We use a midlateral approach to transfer the volar half of the abductor pollicis brevis to the radial insertion of the A1 pulley distal to the MP joint. The transfer should be with maximum tension with the joint in 20 degrees of flexion. We protect this transfer with immobilization for 1 month.