Abstract
Background: Morphometric knowledge of the sternum is of great significance in cardiac surgery as variations in sternal dimensions have been considered a risk factor for translocation of suture material during median sternotomy, leading to poor outcomes. Fatalities attributed to subnor- mal sternal thickness have also been reported during sternal biopsies. Fractures of the sternum secondary to chest injury or cardio-pulmonary resuscitation may also be influenced by sternal thickness. Elongated xiphoid process can be mistaken for an epigastric mass which can be painful on palpation. Morphometric studies of African sterna are rare. The objective is to the study sought to describe the morphometry of adult sterna from the Galloway bone collection, Makerere University, Kampala, Uganda. Subjects and Methods: This study employed a descriptive cross sectional design to collect and analyze quantitative data. Eighty five dry adult sterna (75 males and 10 females) were examined at the Department of Human Anatomy, Makerere University. Data analysis at univariate and bivariate levels were performed using SPSS version 21.0 statistical software. Results:A significant difference in the average length of the mesosternum was found between males at 94.6 mm (SD 11.2) and females at 82.2 mm (SD 15.2) (P=0.002). Two cases (9.5%) presented with elongated xiphoid process and one (1.2%) with subnormal mesosternal thickness. Conclusions: Our study highlights the importance of knowledge of the sternal morphometry in sex identification, physical examination, sternal puncture and other thoracic procedures, calling for increased awareness of the findings.
Highlights
Morphometric knowledge of the sternum is of great significance in cardiac surgery, considering the fact that midline splitting of the sternum is the most commonly used method to access mediastinal structures. [1] During this operation, the sternum is split into halves from the suprasternal notch to the caudal end of the xiphoid process
Variations in the dimensions of the sternum has been reported as a risk factor for translocation of suture material across the sternum during this surgical intervention, [2,3] leading to poor outcomes
An elongated xiphoid process can be mistaken for an epigastric mass which can be painful on palpation. [10]
Summary
Morphometric knowledge of the sternum is of great significance in cardiac surgery, considering the fact that midline splitting of the sternum is the most commonly used method to access mediastinal structures. [1] During this operation, the sternum is split into halves from the suprasternal notch to the caudal end of the xiphoid process. The authors concluded that the sterna of Kenyan origin varied in morphometry from those reported elsewhere and that the variations may present challenges during median sternotomy and may make the bones prone to fractures. Morphometric knowledge of the sternum is of great significance in cardiac surgery as variations in sternal dimensions have been considered a risk factor for translocation of suture material during median sternotomy, leading to poor outcomes. The objective is to the study sought to describe the morphometry of adult sterna from the Galloway bone collection, Makerere University, Kampala, Uganda. Two cases (9.5%) presented with elongated xiphoid process and one (1.2%) with subnormal mesosternal thickness. Conclusions: Our study highlights the importance of knowledge of the sternal morphometry in sex identification, physical examination, sternal puncture and other thoracic procedures, calling for increased awareness of the findings
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