Morphometry of The Sternum in Osteosynthetic Reconstruction

Introduction: Osteosynthetic reconstruction of the sternum can be challenging in thoracic surgery. Osteometric data on the complex anatomy of the sternal bone is needed for the choice of appropriate reconstruction techniques. Sternum clips may be an alternative to current available osteosynthesis. Materials & Methods: Width, intercostal distances, thickness and length of the sternum as well as the distance of the internal thoracic arteries were analyzed in 50 patients who had undergone chest CT. Gender-specific correlation analyses between height, weight and sternum measurements were performed. It was investigated whether sternum clips are the right size to be used on patients concerning osteometric parameters. Results: 50 patients (m:f = 31:19) aged 64.3 (14.3) years were examined. Body dimensions were 171.4 (9.4) cm height and 76.7 (14.8) kg weight. Osteometric data of the sternum could be assessed as follows: length 53.4 (5.9) mm for manubrium, 98.8 (14.0) mm for corpus and 46.5 (10.7) mm for xiphoid process. The vertical distance between two adjacent intercostal spaces was 29.0 (7.4) mm. The distance to the internal thoracic artery was 14.6 (1.3) mm. A correlation between body dimensions and bone morphometry could be found for the length of the sternum. There are gender-specific differences in length, but not in width. Conclusion: The suitability of sternum clips regarding their size and dimensions could be anatomically demonstrated for almost all sternum bones. However, this cannot be done in all cases on the manubrium and the costal arch. Osteosynthesis can be adapted to the sternal dimensions of the individual patient.