Modified Eaton-Littler's Reconstruction for Traumatic Thumb Carpometacarpal Joint Instability: Operative Technique and Clinical Outcomes

Abstract

Background Injuries to thumb carpometacarpal joint ligaments lead to instability. Eaton-Littler's ligament reconstruction traditionally uses a strip of flexor carpi radialis to stabilize the CMC joint.

Study Description We have modified this technique to reproduce the direction of active action of the anterior oblique ligament by reconstructing both the volar and dorsoradial ligaments. In this prospective study, we evaluated patients with confirmed traumatic thumb CMC joint instability who underwent modified Eaton-Littler's reconstruction. Strength analysis, Michigan Hand Outcome Questionnaire, QuickDASH, and subjective outcome measures were collected pre- and postoperatively with minimum 3 years of follow-up. Eleven patients were included in the final analysis, with mean age of 29 years (range: 16–52) and average follow-up of 6.2 years (range: 3–11). There was a statistically significant improvement in all outcome measures.

Clinical Relevance Our modified technique helps to simultaneously address both volar and dorsal ligaments and yields satisfactory clinical outcomes at medium term follow-up.

Level of Evidence Level IV, case series.

Keywords

Eaton-Littler's ligament reconstruction - operative technique - prospective study - outcome measures - thumb carpometacarpal joint instability

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