Another approach was to place a silastic nipple in the base of the metacarpal. This was originally designed as a neurosurgical burr hole cover. Dr. Herbert Stark placed this into the base of the first metacarpal and Dr. Charles "Ray" Ashworth put this into the opposite side of the MC-T joint into the trapezium.
The image above shows the nipple prosthesis inserted into the base of the first metacarpal. This idea inspired the Ashworth-Blatt silastic prosthesis, the stem of which was inserted into the trapezium.
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