In vivo motion of the scaphotrapezio-trapezoidal (STT) joint.

Abstract

It has previously been shown that the articulation of the scaphotrapezio-trapezoidal (STT) joint can be modeled such that the trapezoid and trapezium are tightly linked and move together on a single path relative to the scaphoid during all directions of wrist motion. The simplicity of such a model is fascinating, but it leaves unanswered why two distinct carpal bones would have a mutually articulating surface if there were no motion between them, and how such a simplistic model of STT joint motion translates into the more complex global carpal motion. We performed an in vivo analysis of the trapezoids and trapeziums of 10 subjects (20 wrists) using a markerless bone registration technique. In particular, we analyzed the centroid spacing, centroid displacements, kinematics, and postures of the trapezoid and trapezium relative to the scaphoid. We found that, on a gross level, the in vivo STT motion was consistent with that reported in vitro. In addition, we found that the magnitude of trapezoid and trapezium motion was dependent upon the direction of wrist motion. However, we also found that when small rotations and displacements are considered there were small but statistically significant relative motions between the trapezoid and trapezium (0.4 mm in maximum flexion, 0.3 mm in radial deviation and at least 10 degrees in flexion extension and ulnar deviation) as well as slight off-path rotations. The results of this study indicate that the STT joint should be considered a mobile joint with motions more complex than previously appreciated.