This article describes a novel technique of suspending the first metacarpal after trapeziectomy with a palmaris longus tendon graft in the specific situation of a patient with Eaton and Lambert stage IV thumb base osteoarthritis with proximal subluxation of the first metacarpal and ulnar translation of the carpus on the radius, such that without suspension the first metacarpal would articulate with the radial styloid after trapeziectomy. The advantage of the palmaris longus tendon graft as opposed to techniques using the flexor carpi radialis or abductor pollicis longus tendons is that this technique anchors the first metacarpal in a more distal position than the latter techniques allow. No complications were encountered and the patient remains pain-free at 6 months with improved pinch and grip strength and function.
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