Basal thumb metacarpal osteotomy for first carpometacarpal osteoarthritis

Surgical Principles Osteoarthritis of the first carpometacarpal (CMC) joint is very common. The thumb often develops an adduction deformity with hyperextension of the metacarpophalangeal joint. The basal joint subluxes. Excision of a basal wedge corrects the lack of extension. Other poorly understood benefits of osteotomy including decompression of the medullary circulation, and postoperative increase in the periarticular blood supply may help symptom relief. This procedure has less complications and easier rehabilitation than alternatives including trapeziumectomy with or without tendon interposition, silastic or joint replacement, or arthrodesis. This procedure was first described by Wilson [2] in 1973.