Ligament Reconstruction of the Thumb Carpometacarpal Joint using a Modif ied Eaton and Littler Technique

A modification of the Eaton and Littler technique for reconstructing ligaments and restoring stability of the carpometacarpal joint of the thumb is described. We use a strip from the flexor carpi radialis tendon, which is split down to the crest of the trapezium. The tendon strip is led beneath the ligaments and the abductor pollicis longus insertion, through a tunnel drilled in the metacarpal base, around the insertion of the flexor carpi radialis tendon and finally back to the dorsum of the base of the metacarpal where it is inserted in the periosteum. This procedure ensures'a dynamic fixation of the apical ligament and therefore a better stability. A painless and stable carpometacarpal joint is essential for power in thumb function, especially in pinch and opposition. Instability of this joint due to idiopathic hypermobility' ~ or trauma may lead to repeated subluxa-tion and cause considerable pain. In 1973 Eaton and Littler described their method of reconstructing ligaments and stability of the carpometacarpal joint of the thumb, using a strip from the flexor carpi radialis tendon. We have found it difficult to obtain full stability when using their technique and therefore--as even minor dislocation may cause complaints--we have modified their original procedure