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

• Published in: Journal of wrist surgery 2018-07, Vol.7 (3), p.191-198
• Main Authors: Iyengar, Karthikeyan P., Matar, Hosam E., Loh, William Y. C.
• Format: Article
• Language: English
• Subjects: Scientific; Scientific Article
• ISSN: 2163-3916; 2163-3924
• DOI: 10.1055/s-0037-1607423

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.