Ligament Reconstruction for the Painful Thumb Carpometacarpal Joint

Classifications in Brief: The Eaton-Littler Classification of Thumb Carpometacarpal Joint Arthrosis

“…In 1967, Richard Eaton and William Littler developed a ligament reconstruction procedure for refractory thumb CMC arthritis that reinforced the joint capsule in two planes [11,12]. They subsequently described four progressive radiographic stages of CMC arthritis in 1973, which later was modified to include scaphotrapezial arthritis [10].…”

“…Although Eaton and Littler described their radiographic classification to be used to guide surgical intervention [12], the radiographic presence of basilar thumb arthritis is nearly inevitable with age [4], and surgery should be considered only if extensive nonsurgical treatment options have been exhausted and lifestyle limiting pain and disability persists.…”

“…The Eaton-Littler classification describes four stages of CMC arthrosis based on a true lateral radiograph of the trapeziometacarpal joint of the thumb with the sesamoid bones superimposed on one another [10,12].…”

“…This stage often is present in young women with generalized ligamentous laxity who have pain with use [3]. Eaton and Littler described this stage as the synovitis phase before the onset of more severe capsular laxity [12].…”

“…This stage often is seen in active women in the Each author certifies that he or she has no commercial associations (eg, consultancies, stock ownership, equity interest, patent/licensing arrangement, etc) that might pose a conflict of interest in connection with the submitted article. 3 CMC joint subluxation [12].…”