Interesting Image / İlginç Görüntü
Turk Gogus Kalp Dama 2015;23(4):783-784
doi: 10.5606/tgkdc.dergisi.2015.10462
Fragmented sternum
Parçalı sternum
Nurettin Yiyit,1 Hasan Saygın2
Deparments of 1Thoracic Surgery, 2Radiology, GMMA Haydarpaşa Training Hospital, İstanbul, Turkey
Twenty-one-year-old two patients with blunt chest
trauma history due to traffic accident were admitted
to our hospital on different dates. Both patients
were evaluated with plain radiographs and computed
tomography. Multiple fissure lines on corpus sternum
were revealed in the lateral radiographs of each patient
(Figure 1a, 2a). Two transverse fissures dividing
corpus sternum to three parts were observed in
the computed tomography images of both patients
(Figure 1b-d, 2b-d).
Sternal cleft is the fusion defect of the sternum
that separates the sternum partially or completely
into two vertical parts. Fragmented sternum has not
been defined previously. Two sternal cartilaginous
bars fuse between 7th and 10th weeks of the fetal
life. The cartilaginous sternum ossifies from six
(a)
(b)
(a)
(b)
(c)
(d)
(c)
(d)
Figure 1. (a) Lateral chest radiograph of first patient demonstrating
fissure lines on corpus sternum. (b) Sagittal, (c) coronal (d) and
three-dimensional computed tomography images demonstrating
transverse fissures dividing corpus sternum to parts.
Available online at
www.tgkdc.dergisi.org
doi: 10.5606/tgkdc.dergisi.2015.10462
QR (Quick Response) Code
Figure 2. (a) Lateral chest radiograph of second patient
demonstrating fissure lines on corpus sternum. (b) Sagittal,
(c) coronal and (d) three-dimensional computed tomography
images demonstrating transverse fissures dividing corpus
sternum to parts.
Received: June 03, 2014 Accepted: August 17, 2014
Correspondence: Nurettin Yiyit, M.D. Gülhane Askeri Tıp Akademisi Haydarpaşa
Eğitim Hastanesi, Göğüs Cerrahisi Kliniği, 34668 Üsküdar, İstanbul, Turkey.
Tel: +90 532 - 510 86 80 e-mail: [email protected]
783
Turk Gogus Kalp Dama
(a)
(b)
(Figure 3a). The union of bone segments formed
from ossification centers of corpus sternum proceeds
until the age of 25.[1] Therefore, the corpus of
the sternum might be seen as separated into parts
in radiological examinations under the age of 25
(Figure 3b). This finding is not a pathological
condition which requires additional treatment or
operation. To avoid misdiagnosis especially in trauma
patients, fragmented sternum should be known as a
normal manifestation of sternal ossification.
Declaration of conflicting interests
Figure 3. (a) Appearance of six ossification centers
of cartilaginous sternum. (b) Appearance of bone
segments formed from ossification centers of sternum.
different centers. Two of the six ossification centers
are localized in the manubrium and xiphoid process.
Other four centers are placed in the corpus sternum
784
The authors declared no conflicts of interest with
respect to the authorship and/or publication of this
article.
Funding
The authors received no financial support for the
research and/or authorship of this article.
REFERENCES
1. Gatzoulis MA. Thorax. In: Standring S, editor. Gray’s
Anatomy. China: Elsevier; 2008. p. 917-8.