An unstable CMC I joint causes pain and dysfunction. Chronic subluxation can lead to cartilage damage and furthermore to rhizarthrosis. This study should evaluate the results of the Eaton Littler ligament reconstruction, in which a slip of the Flexor carpi radialis tendon (FCR) weaved through the basis of the first metacarpal and around the tendon of the Abductor pollicis longus and back to the FCR. Aftertreatment consists in 4 weeks cast, 4 weeks thermoplastic splint and physiotherapy, full opposition is allowed after 8 weeks.

We performed 10 operations in 8 patients with a mean age of 35.9 years (6 female, 2 male). In 8 times the diagnosis was a rhizarthrosis Eaton Littler stadium I and in 2 times a posttraumatic instability. The mean follow up time was 15.4 months. We evaluated subjective satisfaction with the Disabilities of the Arm, Shoulder and Hand Score (DASH), pain with the visual analogue scale (VAS) and the patients were asked, if they would undergo the operation again. Furthermore the range of motion (ROM) was examined, the strengths (key and pin grip) were measured and radiographs were made.

All patients would undergo the operation again. The mean DASH score was 17.4 points, the mean VAS in rest 0 and under stress 1.29. The mean pin grip strength was 3.98 kg and the mean key grip strength 7.14kg. The ROM was excellent with a mean anteposition of 39.5°, a mean abduction of 49.3°. The mean thumb opposition was Kapandji 9.9. Radiological there was no progression of the Eaton Littler stadium. As complications occurred 1 keloid and 1 hypaesthesia.

Our experiences with the Eaton Littler procedure for stabilisation of the hypermobile thumb saddle joint were positive. Long time results will show, if the procedure can prevent cartilage damage and progression of rhizarthrosis.

Introduction: Ulnocarpale Impaction Syndrom is defined as a degenerative disease on the basis of a relative mis-proportion in lenghth ratio between ulnar and radius, caused either by posttraumatic degeneration or idiopathic history. This causes an unusual high load bearing in the ulnar carpale joint as well as in the distal radio – ulnar joint. All these factors lead to a degeneration of the triangular discus, secondary lunotriqutral instability and chondromalazia of ulna, lunate bone and the triquetral bone.

Ulnocarpale Impaction Syndrom is diagnosed by clinical evaluation as well as typical radiologic findings. If non operative treatment leads to unsatisfactory results few operative options can be considered. Ulnar shortening osteotomy is one of them.

Material and Methods: From 2003 until 2006, 10 Patients were treated. 3 female patients and 7 male patients, with an average age of 46 years and/or 42,7 years were operated on. We evaluated forearm rotation, power, DASH Score, Numeral Analogue scale and radiologic findings considering ulnar lenghth and bone consolidation.

Results: Painfree forearm rotation increased significantly postoperatively. An increase in power was seen as well as a reduction of the DASH score of 51,6 points. Also the numeral analogue scale showed a reduction of 5 points. Postoperatively the ratio of ulnar to radial lenghth was nearly equal (average of ulnar -1mm) and all osteotomies showed normal bony healing.

Conclussion: Surgical therapy of painful ulnar impaction syndrom using ulnar shortening osteotomy seems to be a very feasible and practical procedure. In comparison to resection arthroplasty and the wafer procedure, ulnar shortening osteotomy shows no significant increase of pressure in the sigmoid fossa. Therefor it is the treatment of joice in our departement.