One-stage key pinch and release procedure (dorsal and lateral views). Thumb is prepositioned for lateral pinch by arthrodesis of trapezium–first metacarpophalangeal joint in 20 to 25 degrees of extension, 40 to 45 degrees of abduction, and slight pronation. Extensor pollicis longus (EPL) is fixed to Lister tubercle of distal radius by tenodesis. Brachioradialis (BR) or extensor carpi radialis longus (ECRL) is mobilized into proximal forearm and transferred to flexor pollicis longus (FPL) distally.