Abstract Aim There are various surgical options for the management of thumb carpometacarpal joint (CMCJ) arthritis. These include first metacarpal osteotomy, trapeziectomy with or without ligament reconstruction, CMCJ arthrodesis and arthroplasty. However, if these operations fail, salvage limited. The authors aim to offer ‘first second (FSMA)’ as a procedure failed CMC surgeries. also reviewed...