Study of Sutures: Anatomical Variations in the Fusion of Sutures

2022

Background: The metopic suture (MS), at the vertical axis between the two halves of the frontal bone appears as the result of lack of ossification. Its persistence is called metopism. The current study records the frequency of MS persistence, its morphological variants, and its coexistence with Wormian bones (WBs) in adult skulls. Material – Method: Eighty (41 male and 39 female) Greek adult dried skulls were investigated for the MS presence. For a further MS evaluation, the skulls were divided into 3 groups: 1 st group ( MS absence ), 2 nd group ( complete MS ) and 3 rd group ( incomplete MS ). The incomplete MS was classified into the following morphological variants: Y, V, U, H shapes and linear and double linear types. Skulls used were also inspected for the WBs presence. Results: The MS was identified in 69 skulls (86.25%). Its absence was found in 11 skulls (13.8%) with similar frequencies in males and in females. The incomplete MS was prevalent (78.8%), while the complete one...

Journal of Craniofacial Surgery, 2014

The metopic suture (MS) lies on the midline of the forehead and extends from the frontal bone to the root of the nose. The aim of the current study was to evaluate morphologic features of the complete and incomplete MSs of skulls in the West Anatolian population and rates of the suture types. One hundred sixty crania of West Anatolian people with unknown ages and sex belonging to the anatomy department laboratory of Dokuz Eylül University Medical School were examined. When the MSs that extend from the nasion to the bregma are complete, this condition was named as metopism. The length of the complete sutures was measured using a flexible millimeter calibrated ruler. If the suture was not present throughout between these 2 landmarks (nasion and bregma), these were considered as the incomplete MSs. The incomplete MSs were classified as linear, V-shaped, and double types. The incidence of the complete and incomplete sutures was 75%. The complete (metopism) and incomplete MSs were found in 7.50% and 67.50% of the skulls, respectively. The most common type was linear (39.40%), followed by double shaped (23.10%) and V shaped (5%). The mean length of the complete MS was 12.30 cm. Because the localization and types of MSs are important during clinical approaches, while evaluating patients with head trauma in the emergency department, these should be considered.

Folia morphologica, 2004

The metopic suture of 24 adult skulls investigated showed recognisably varied morphological patterns. The metopic suture resembled wavy lines and was sometimes highly convoluted, especially in the superior part of the frontal bone. The mean suture length was computed as 123.1 mm (SD = 5.307) and the mean fractal dimension was 1.17 (SD = 0.076). Visual inspection of the morphological character of the metopic sutures revealed complex variation in their course between the nasion and the bregma. Comparison of the fractal dimensions indicated a two-fold increase in complexity between the anterior half of the suture terminating in the nasion (FD = 1.10) and the second half of the suture beginning in the bregma (FD = 1.21). The Mann-Whitney test confirmed the statistical significance of the differences in the fractal dimensions calculated. The variety and complexity of the interdigitations in the anterior and posterior part of the suture point to possible alterations to local strains, which occur during the growth of the braincase.

Journal of Craniofacial Surgery, 2006

Current knowledge of suture biology has been ascertained as a result of morphological studies of normal cranial sutures (and rarely those undergoing craniosynostosis). These were initially undertaken often using histological investigations, or more recently using CT scans, as investigative tools, but have often used animal models. However, recent technological advances have provided the potential to refine our understanding of the ultrastructure by the use of new advanced scanning technology, which offers the possibility of more detailed resolution. Our aim was to undertake detailed scans of normal, fusing and fused sutures from patients with craniosynosotosis affecting different sutures, to study the detailed structure at different stages of the fusion process using a modern micro-CT scanner and a microanalytical scanning electron microscope. We wished to include in our study all the human sutures because previous studies have mostly been undertaken using the sagittal suture. Ten sutures from seven patients have revealed a complex ultra-structural arrangement. The different patterns of bone ridging seen on the ectocranial and endocranial surfaces of the fused sagittal suture were not repeated on closer inspection of either fused coronal or lambdoid sutures. Elemental analysis confirmed that the amount of calcium increased and the amount of carbon decreased as sampled areas moved away from the suture margin. We conclude that scanning allowed detailed assessment and revealed the complex arrangement of the structure of the human cranial sutures and those undergoing the process of craniosynostosis, with some differences in final structure depending on the affected suture.

2017

Introduction: At birth the frontal bone contains two portions, separated by the metopic (frontal) suture. Metopism is the condition of having a persistent metopic suture. Aim of the present study was to determine the incidence of persistence of metopic suture, their shape and its relation to age and sex in Egyptian human skulls. Material and Method: The study was conducted on 147 human dry skulls which belong to the museum of the department of Anatomy, Faculty of Medicine, Menoufia University. The metopic sutures were classified as complete and incomplete types. Incomplete metopic sutures were divided into three groups as present in the lower part of the frontal bone, in the upper part and in the middle part. The incomplete lower metopic sutures were further subdivided into linear, ‘V’ shaped and ‘U’ shaped. Results: From this study, absence metopic sutures were observed in 84 (57.1%) skulls, while it was present in 63 (42.9%) ones. The complete metopic suture (metopism) was seen in...

Turkish Neurosurgery, 2011

AIm: To determine the incidence of metopic suture in Indian human adult skulls and to study their morphology. mAterIAl and methOds: The study included 81 human adult dry skulls which were obtained from the neuroanatomy laboratory of our institution. The skulls were macroscopically inspected at the norma frontalis for the presence of the metopic suture and the sutures were morphologically analyzed. The sutures were classified as complete and incomplete types. The incomplete ones included linear type, 'V' shape and double type. results: From our observations, the metopic suture was present in 52 (64.1%) cases. The complete metopic suture was seen in only 1 skull (1.2%). The majority of the metopics were of incomplete type, 51 (62.9%). Among the incomplete ones, 18 (22.2%) were linear, 17 (21%) were 'V' shaped and 16 were double metopics (19.7%). No metopic sutures were associated with the Wormian bones. COnClusIOn: The morphological knowledge of the metopic suture is important for the radiologists and neurosurgeons in day to day practice. While reading the X-ray / CT and MRI films, the possibility of the metopic suture should be kept in mind. This will prevent confusion and a wrong diagnosis in emergency situations.

National Journal of Medical Research, 2013

Introduction: Metopic suture which is placed between frontal bone and usually disappear during infancy and childhood, may persist from nasion to anterior angle of bregma, this is called metopism. Objective: To find the incidence of metopism in western Rajasthan and to compare it with other study in other parts of India and Abroad. Methodology: Present study was autopsy done on 200 dead bodies of all age group who were brought to J L N Medical college, Ajmer for autopsy during the period of 6 months. Vault was observed morphological for presence of metopism on both outer and inner side after removal of periosteum. Results: The incidence of metopism was 6.5% in all observed skull in this study. The incidence of metopism was observed more in child age group i.e. 100% in 0-5 years & 80% in 6-10 years as compare to the adults and old age groups i.e. 3.4% in 41-50 years. Conclusion: The presence of metopic suture simulates the fracture of frontal bone, therefore it should be properly ruled out in x-rays by radiologists and neurosurgeons.

International Journal of Anatomy and Research, 2019

Background: Cranial sutures and their evolution is interesting in the field of cranial growing and shaping. It is a dentate suture extending from nasion to bregma. Metopic suture normally closes at 1-3 yrs, but is allowed up to 8 yrs. Incidence varies in different races from 1%-12%. Aim: The present study was done to know the incidence of Metopic suture in south Indian skulls. Materials and Methods: 100 skulls from the Anatomy Dept museum at Shridevi Institute of Medical Sciences Tumkur were collected for the present study. The skulls with persistent metopic suture were thoroughly observed. Results: Metopic suture was present in 38%. Complete suture was seen in 3% and incomplete in 35%.Among the 3 complete sutures one was linear and continue with sagittal suture measuring 12.3 cm and 2 were H shaped measuring 11.0 cm and 12.1 cm. Incomplete sutures were classified depending on the shape U, V, Y and linear. Linear suture was seen in 26 skulls, U shape in 4 skulls, V shape 4 skulls, Y shape 1 skull. Conclusion: The presence of metopic suture is important from a clinical point of view. It must be included in differential diagnosis of suspected skull fracture particularly frontal bone. It is not a pathological entity but most certainly should be noted as an incidental finding on an X ray. The suture is best identified in A-P view of skull.

2010

The aim of the study was to assess the normal and synostosed coronal cranial sutures morphology at an ultrastructural level. Different operative specimens of human coronal sutures were collected. Three-dimensional reconstruction of the microcomputed tomography (micro-CT) slices were obtained and compared with the representative histologic sections. The micro-CT scanning provides a three-dimensional view of the sutures at a microscopical level thus allowing to establish the stage of development and the bone morphology. The micro-CT has the advantage of being able to image more slices than the normal histology without any damage to the analyzed specimens. Micro-CT is a powerful tool in the craniofacial area that allows us to obtain many structure-orientated slices and in conjunction with the histologic sections provides an overall thorough quantitative analysis of all cranial sutures.

Springer , 2021