54 patients (57 thumbs) with chronic, non-degenerative hyperlaxity of the thumb and undergoing surgical stabilization of the thumb carpometacarpal joint were included in a cohort study, of which 16 patients were randomized to undergo the procedure through either a volar or dorsal approach. The purpose of the pilot randomized controlled trial was was to compare the results of the two approaches. Pain, grip strength, key pinch strength and ADL function were measured at 3 months and 12 months postoperatively. The pilot RCT was terminated after only 8 patients had been allocated to each group, citing poorer outcome in the dorsal group compared to the volar group. More specifically, pain was observed to be significantly higher in the dorsal group at 3 months in comparison to the volar group. When all 54 patients of the cohort study were evaluated together, pain, Michigan Hand Questionnaire (MHQ) scores, grip strength and pinch strength were observed to have significantly improved from baseline to 1 year.