Reconstruction of the thumb basal joints. Development and current status of implant techniques.

The problems presented at the thumb basal joints differ in osteoarthritis and rheumatoid arthritis. Therefore, the proper treatment must be selected from several options including resection of the trapeziometacarpal joint with or without a convex or concave condylar implant and resection arthroplasty of the trapezium with or without a trapezium implant. Proper medialization of any basal thumb implant and stability over the scaphoid facet are essential for a good result. Balance of the entire thumb ray is critical and stabilization or fusion of the distal articulations of the thumb may also be considered.