I summarize my changing views and practices of arthroplasty in hand surgery over the past four decades. I recommend simple resection of the trapeziectomy for advanced arthritis of the first carpometacarpal joint, silicone implants for the metacarpophalangeal joints and the proximal interphalangeal joints, and the total wrist arthroplasty for advanced wrist arthritis and collapse. I also outline technical tips of these procedures.
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