Morphometric assessment of sternal foramina and sternal variations

Abstract

The sternum is a crucial component of the thoracic cage. Its articulations and divisions play an important role in providing structural support to the thoracic cage and facilitating movements. The body of the sternum originates from four mesenchymal bars known as sternebrae, Incomplete fusion of the sternebrae or failure of fusion can lead to the development of a sternal foramen. The clinical significance of a sternal foramen lies in the potential risks associated with medical procedures such as acupuncture or sternal puncture for bone marrow biopsy. A study was conducted on 100 sterna at K. J. Somaiya Medical College to find out the presence of sternal foramen, to study their site, size and shape and to discuss its clinical Implications. 20% of the specimens were found to possess a sternal foramen. The vertical to transverse diameter of these foramina were in the range of 4.4 – 6.9mm. Most of the foramen were found to be at the level of 3 and 4 costal notches followed by Xiphoid process. The study also observed the variations in the shape of the manubrium and the body of the sternum and the variations of the Xiphoid process. Failure to recognize the presence of sternal foramina can pose serious risks during medical procedures, potentially leading to damage to the pericardium and heart. Therefore, it is essential for healthcare practitioners to be aware of these variations and consider obtaining X-ray or CT scans to assess sternum morphology before performing invasive procedures. The study emphasizes the importance of comprehensive anatomical knowledge and careful clinical assessment when dealing with the sternum and underscores the need for precautionary measures to prevent complications associated with sternal foramina.