[Resection arthoplasty of the trapezium with ligament reconstruction and tendon interposition and variations].

Objective: Creation of a pain-free, flexible and stable (pseudo) joint between the carpus and the base of the 1st metacarpal bone.
Indications: Painful carpometacarpal (CMC)‑I joint due to primary or secondary osteoarthritis, CMC‑I instability.
Contraindications: Carpal instability, local infection, tumors.
Surgical Technique: Resection of the trapezium (and of the arthritic joint surfaces in CMC‑I and STT [scaphoid-trapezium-trapezoid-joint]), stabilization of the base of the 1st metacarpal bone by suspension with a distally pedicled strip of the flexor carpi radialis tendon or variants thereof.
Postoperative Management: Immobilization in a splint for 3-5 weeks, followed by hand therapy.
Results: Worldwide for almost 40 years, regardless of the exact technique, almost always (90%) significant pain reduction, increased strength in the grip and slightly less in the pinch grip, very good mobility, 85-95% very satisfied patients and very good long-term results.