What Eaton stage warrants trapeziectomy?

Eaton Stage III-IV with failed conservative management (splinting, injections) typically warrants surgical intervention. Trapeziectomy with ligament reconstruction and tendon interposition (LRTI) achieves 80-90% patient satisfaction.

How is thumb CMC OA treated conservatively?

Stage I-II: thumb spica splint (day use or nighttime only), NSAID topical/oral, intraarticular corticosteroid injection (3-6 months relief), activity modification. Splinting reduces pain during pinch-intensive activities.

What is the evidence for trapeziectomy alone vs LRTI?

Cochrane review 2015 and TRIPOD trial found trapeziectomy alone gives equivalent results to LRTI at 1-5 years. Trapeziectomy alone is simpler with shorter recovery. Both achieve comparable DASH and pain scores at 1-2 years.

Eaton Classification for Thumb CMC Osteoarthritis

Apply Eaton-Littler-Melone classification (Stages I-IV) for thumb carpometacarpal (CMC/basal joint) osteoarthritis. Stage I = normal joint space, synovitis only. Stage IV = complete joint space loss with radial subluxation and STT involvement. Guides injection, splinting, and surgery.

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Frequently Asked Questions

What Eaton stage warrants trapeziectomy?

How is thumb CMC OA treated conservatively?

What is the evidence for trapeziectomy alone vs LRTI?