TechniquesFirst Carpometacarpal Joint Instability: Dorsal Ligament ReconstructionZeba, Nenad MD*; Horvath, Alexandra MD†; Wallmon, Anders MD* Author Information *HandCenter Göteborg †Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy, Gothenburg, Sweden Conflicts of Interest and Source of Funding: The authors report no conflicts of interest and no source of funding. Address correspondence and reprint requests to Anders Wallmon, MD, HandCenter Göteborg, Fabriksgatan 10, Gothenburg SE-412 50, Sweden. E-mail: [email protected]. Techniques in Hand & Upper Extremity Surgery: September 2021 - Volume 25 - Issue 3 - p 169-174 doi: 10.1097/BTH.0000000000000327 Buy Metrics Abstract The first carpometacarpal (CMC-I) joint has an elaborate ligamentous support. Recent evidence has demonstrated that the dorsal ligament group is imperative for joint stability and that CMC-I joint instability may occur as a consequence of trauma and ligamentous laxity, and other conditions, with possible CMC-I subluxation and the development of osteoarthritis. Although various surgical techniques have been introduced for the treatment of ligamentous CMC-I instability, the Eaton-Littler reconstruction has been regarded as the gold standard. It is widely accepted that impaired hand function may still be present following the reconstruction of the CMC-I joint ligaments, demonstrating the existing limitations of current surgical techniques. In this paper, a novel extra-articular technique relating to CMC-I joint instability and focusing on the dorsal ligament group is described. A graft taken from the abductor pollicis longus tendon is utilized to reconstruct the dorsal radial ligament and posterior oblique ligament. This technique may provide a less invasive alternative than the gold standard procedure and the hypothesis is that it will lead to a better outcome. Copyright © 2020 Wolters Kluwer Health, Inc. All rights reserved.