The Mini TightRope® provides a unique means to stabilise the thumb metacarpal after a trapezial resection or removal for treatment of CMC arthritis. The Mini TightRope® can also be used as an adjunct and stabiliser in CMC instability and in the case of revision with proximal migration after tendon reconstruction. The Mini TightRope® uses a pulley principle to help reduce the thumb and index metacarpals into the proper relationship, that is maintained through healing. The construct consists of four passes of #2 FiberWire® through two stainless steel buttons. The FibreWire® suture has minimal stretch allowing only micro-motion to promote scarring. The Mini TightRope® technique stabilises and protects the biological repair via a solid and stable suspensionplasty which potentially allows earlier rehabilitation.