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Mnemonics, Simplified Concepts & Thoughts

Basilar Thumb or 1st CMCJ Osteoarthritis

Epomedicine, Apr 17, 2025Apr 17, 2025

Last updated on April 17, 2025

Tips to remember this classification include:

  1. If the trapezio-metacarpal joint (1st CMCJ) is widened: stage is ≥1
  2. If the trapezio-metacarpal joint (1st CMCJ) is narrowed: stage is ≥2
  3. If osteophytes are >2mm: stage is ≥ 3
  4. If scapho-trapezial joint is narrowed: stage is ≥ 4
Eaton StageJointSubluxationOsteophyteSurgery
I1st CMCJ widened<1/3NoVolar Ligament Reconstruction
II1st CMCJ narrowed<1/3<2 mm1. Ligament reconstruction with tendon interposition (LRTI)

2. Single interposition

3. Suspensionplasty

4. Metacarpal osteotomy
III1st CMCJ severely narrowed≥1/3>2 mmSame as above
IV1st CMCJ obliterated + STT joint narrowedMajor>2 mm1. LRTI

2. Double interposition

3. Suspensionplasty

4. Simple trapeziectomy
eaton littler stage
Colonna, Saverio & Borghi, Corrado. (2024). Rhizarthrosis Part I: A Literature Review. Cureus. 16. 10.7759/cureus.52932. [CC BY 4.0]

Before proceeding to surgery, non-operative treatment trial includes:

  1. NSAIDs for 2-3 weeks
  2. Activity modification
  3. Splint for 3-6 weeks
  4. +/- Corticosteroid injection (Second-line)

Further reading: Basal Thumb Osteoarthritis: Anatomy, Pathophysiology, Diagnosis, Treatment

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PGMEE, MRCS, USMLE, MBBS, MD/MS Musculoskeletal systemOrthopedics

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Epomedicine. Basilar Thumb or 1st CMCJ Osteoarthritis [Internet]. Epomedicine; 2025 Apr 17 [cited 2025 May 9]. Available from: https://epomedicine.com/medical-students/basilar-thumb-or-1st-cmcj-osteoarthritis/.

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