Volar Plate Advancement and Abductor Pollicis Brevis Tenodesis for Thumb Metacarpophalangeal Joint Hyperextension Correction

First carpometacarpal (CMC۱) osteoarthritis can be accompanied by the collapse of the first ray, with hyperextension of the first metacarpophalangeal (MCP۱) joint. It is suggested that failure to address substantial MCP۱ hyperextension during CMC۱ arthroplasty may diminish post-operative capability and increase collapse reoccurrence. An arthrodesis is recommended in case of severe MCP۱ joint hyperextension (>۴۰۰). We describe a novel combination of a volar plate advancement and abductor pollicis brevis tenodesis to address MCP۱ hyperextension at the time of CMC۱ arthroplasty as an alternative to joint fusion. In ۶ women, mean MCP۱ hyperextension with pinch before surgery was ۴۵۰ (range ۳۰۰-۸۵۰) and improved to ۲۱۰ (range ۱۵۰-۳۰۰) of flexion with pinch six months after surgery. No revision surgery has been necessary to date, and there were no adverse events. Long-term outcome data is needed to establish the longevity of this procedure as an alternative to joint fusion, but early results are promising. Level of evidence: IV