gms | German Medical Science

Objectives/Interrogation: Chronic instability of the carpometacarpal (CMC) joint is an injury rarely reported in the literature. We present two patients with that lesion, very similar between them, treated with modified Eaton-Littler's ligament reconstruction.

Methods: Two patients, aged 46 and 49, presented to external consultation with pain on the base of the thumb and instability of CMC joint of their dominant hand. Both of them related their pain to their work.

Clinical examination revealed in the two cases deformity of the CMC joint with a reduced and painful range of movement.

Radiographs of the hand showed CMC subluxation of the thumb without associated fractures and with no signs of osteoarthritis. The study was completed with a CT scan in one case and with a MRI in the other case.

Reconstruction was undertaken using a modified Eaton-Littler technique as described by Iyengar et al (J Hand Microsurg 2013): a FCR slip 2 to 2.5cm short of its insercion is directed in an oblique manner to reproduce the direction of the anterior oblique ligament and, by passing it through a bonny tunnel in the metacarpal base and under the APL, and suturing it back on to itself, it is ensured a reinforcement of the dorsoradial ligament.

Results and Conclusions: At 1 year follow-up evaluation, the patients were pain free with satisfactory thumb functions. They had no radiological evidences of instability or arthritic changes.