Tension band technique for thumb metacarpophalangeal joint arthrodesis. A, Curved dorsal incision. B, Incision through extensor pollicis brevis tendon and radial aponeurotic fibers exposing dorsal capsule. C, Capsule split longitudinally to expose metacarpal head and proximal phalanx base and excise osteophytes, collateral ligaments, and synovitic tissue. D, Exposure of subchondral bone to obtain full contact of raw cancellous metacarpal and proximal phalangeal surfaces. E, Placement of Kirschner wire in distal third of proximal phalangeal neck completing tension band construct. F, Wire twisted and ends buried about fusion site. G, Ends of wires cut and tamped into metacarpal over low-profile construct. H, Postoperative radiographic appearance. SEE TECHNIQUE 73.30.