Sternum as an index for determination of sex

Background: To examine human bones is a challenge for experts, especially in deceased and also for determinationof sex for medico-legal purpose. Measurement of the sternum is done by many authors for determination of sex.Sternum was measured for length of manubrium, length of mesosternum and combined length of manubrium andmesosternum. The data was statistically analysed.Method: The present study was done on 65 human sternums(46 Males and 19 Females). Sternum was extractedfrom cadavers in the Department of Anatomy, People’s College of Medical Sciences and Research Centre, Bhopaland Sternum from Autopsy bodies in the Department of Forensic Medicine and Toxicology, People’s College ofMedical Sciences and Research Centre, Bhopal. (MP),India.Results: If the combined length of a sternum is less than 150 mm then it is of female sternum, if it exceeds 150 mm,it is of male sternum. The mean Sternal Index in male was 43.43 and in females 41.132. 89.13% of male and21.05% of female specimen obey the Hyrtl’s law.Conclusion: The combined length of manubrium and mesosternum is considered as the most important parameter,which when applied to an individual specimen can help in sexing the sterna correctly in our study

Evaluation of Gender in Living Male and Female Children Through the Measurement of Sternum Bone in the Population of Uttar Pradesh

Introduction: Sex evaluation from the skeletal remains is of very much important for medicolegal aspects in the field of medical science. On the basis of previous researcher, I have been planned to verify the existrnal data and establish them in reference to population in and around Lucknow. With the help of this study we were distinguishes the male and female sternum bone in children. Subjects and Methods: The technique described by Ashley GT -1956b was used for measurement of sternum. Each linear measurement has been taken thrice on the anatomical position of the sternum using Mitutoyo-digital vernier calipers to the nearest millimeter with precision of 0.01 mm. Results: Discussion: The previous researchers told that the sternum has distinguished in different zone of India, and it is shorter than European country. Our findings of manubrium were 49.45±3.45 mm for male and 44.47± 5.79 mm for female children respectively. The study done by previous researcher was provided full support to our present finding. Conclusion: The comparison of mean length of manubrium, mesosternum and sternum between 2 to 15 yrs, female and male sternum between two groups, significantly different and higher length of manubrium, mesosternum and sternum in males as compared to females children.

It Is Time the Sternum Gets a New Name.

Names of objects change over a period of time. New words come up to keep in line with innovations and technology. Neologism requires that the new word entrant should be concise, phonetically strong and resemble the function towhich thewordmay be used. Internet language is the latest invention inwhich theword has been so abbreviated that at times the user is frightened that its continuous usage would finally obliterate the real word. To counter that threat old-timers adopt duality in action, i.e., they would use internet language while using internet portfolio and would revert to the old language while scripting text. However, in certain cases it is better to discard the old robe in favor of new when the coined word would instill more confidence and is in harmony to the function it is required to perform. In this way the word is remembered accurately and used with finesse. Presented in this paper is the strong defense for change of the word “sternum” to “saber” and reason why this change is desired.

The Transmanubrial Approach for Cervicothoracic Junction Lesions : Feasibility, Limitations, and Advantages

OBJECTIVE: We report on the technical feasibility and limitations of the transmanubrial approach for cervicothoracic junction (CTJ) lesions and emphasize the advantage of bisecting the upper part of the manubrium in an inverted Y-shape. METHODS: Thirteen patients who underwent the fourteen transmanubrial approach for various CTJ lesions were enrolled during 2005-2014. For the evaluation of the accessibility for the CTJ lesion, we analyzed the two parallel line defined as a straight line parallel to the inferior and superior plateau of the upper and lower healthy vertebrae, the angle of the two parallel lines and the distance from the sternal notch to lines at the sternum on preoperative magnetic resonance images. Surgical limitations and perspectives, as well as postoperative clinical outcomes were evaluated retrospectively. RESULTS: The CTJ lesions were six metastases, three primary bone tumors, two herniated discs, and one each of a traumatic dislocation with syrinx formation and tuberculous spondylitis and ossification of the posterior longitudinal ligament. If two parallel lines pass below the sternal notch, the manubriotomy should be inevitably performed. The mean preoperative Visual analogue scale score was 8 (range, 5-10), which improved to 4 (range, 0-6) postoperatively. Seven cases showed an increase in Frankel score postoperatively. CONCLUSION: The spatial relationship between the sternal notch and the two parallel lines to the lesion was rational to determine the feasibility of manubriotomy. The transmanubrial approach for CTJ lesions can achieve favorable clinical outcomes by providing direct decompression of lesion and effective reconstruction.

Morphometry and Variations of Malleus with Clinical Correlations.

Background: Ossicular morphology and morphometric considerations play cornerstone importance in reconstructive surgeries. An attempt is made to have an insight into such morphological variations and evaluate the morphometric values of malleus in south Indian population through cadaveric dissection. Materials and methods: 25 human head specimens taken from the dissection hall, after removal of brain and duramater, subarcuate fossa and arcuate eminance of the petrous part of the temporal bone were chipped off with help of fine edged chissel and hammer. With help of bone cutter the tegmen tympani forming the remaining roof was removed, till the middle ear cavity and three ossicles are properly exposed and identified. Results: Malleus height ranged from 6.94 mm to 7.78 mm on both sides with average of 7.37mm on right and 7.51 mm on left. Weight ranged from 16.85 mg to 19.25 mg with average of 18 mg on right side and 18.52 mg on left both side. Length and weight of left malleus bones were statistically more than their right counterparts. Conclusions: Morphologically malleus showed lesser variations in comparison to stapes. The left sided malleus dominated the right sided ones in both length and weight.

Morphological variations in human fetal ear ossicles-a study.

Aim: To study the morphological variation, if any, of the ear ossicles in the human fetuses and use of the study in medical applications. Materials and Methods: This study was performed on 100 sets of middle ear ossicles, each set consisting of Malleus, Incus and Stapes, which were taken from 50 fetal cadavers on either side. Observations: All the three ossicles showed variations in their morphology and more so in the stapes. Discussion: There are few studies in the literature on individual differences in these ossicles and these studies were on either adult or different species. Conclusion: the ear ossicles of the destitute human fetuses can be used as homografts to replace eroded adult middle ear ossicles.

Radiological age estimation from sternum.

Introduction: Verification or determination of the age is prerequisite for personal identification in living as well as dead and age estimation is one of the important tasks for a medico-legal practice. Skeletal examination is important for identification of an individual either living or dead especially for the estimation of age. Material and Method: In the present study, authors have tried to work out the criteria for determination of age of the deceased with the help of sternum. Authors have studied 109 sterna procured from the cadavers with known age brought for post-mortem examination at the civil hospital, ahmedabad. Fusion of manubrium and xiphoid process with the body of sternum was studied radiologically. The data thus collected, were analysed statistically and conclusion was drawn. Result: According to the present study, for males, the age of fusion between xiphisterum and body of the sternum is at 42 years, for females, the age of fusion between xiphisterum and body of the sternum is at 44 years. In males, the fusion at manubrio-sternal starts at the age of 50 years and it completes after the age of 59 years but the exact age for complete fusion at manubrio-sternal joint could not be defined. Amongst females, the cases showing first degree fusion are seen increasing from the age of 54 years and complete fusion after the age of 64 years. But here also the exact pattern could not be defined. Conclusion: Estimation of age by radiology will be of very much helpful to the medicolegal experts in determining the age of unknown deceased as well as skeletonised remains.

Antropometría del martillo en humanos: un estudio anatómico directo / Anthropometry of the malleus in humans: a direct anatomic study

El conocimiento morfométrico de las estructuras del oído medio, incluidos cada uno de los oscículos, es importante para la comprensión de su complejidad biomecánica. Las características estructurales y dimensionales del martillo son registradas en 23 martillos de población mestiza adulta Colombiana. Las medidas registradas involucran el área de la cabeza, el cuello, el manubrio, el proceso anterior y lateral y el área de la articulación incudo-maleolar. Tres de los diecinueve registros tomados en este estudio pudieron ser comparados concienzudamente con otros estudios que mostraron similitudes. El largo total del martillo fue de 8,18 mm DE 0,24, la longitud del manubrio fue de 4,91 mm DE 0,25 y la proporción del largo del manubrio y el largo total fue de 60,11 % DE 3,47. Conforme a la población estudiada no se logro encontrar variación individual o pareada en la anatomía del martillo lo que lo hace un hueso morfométricamente uniforme y estable.

Morphometric knowledge of middle ear structures, including each of the oscicles, is important for the understanding of its biomechanics complexity. The structural and dimensional characteristics of the malleus are registered in 23 samples of Colombian adult mestizo population. Registered measures involve the area of the head, neck, the manubrium, the anterior and lateral process and the area of the incudo-maleolar joint. Three of nineteen records taken in this study could be carefully compared to other studies, which showed similarities. The total length of the malleus was 8,18 mm SD 0.24, the length of the handle was 4.91 mm SD 0.25 and the ratio of the length of the manubrium and the malleus total length was 60,11% of 3.47. In accordance with the studied population, individual or paired variations were not found in the anatomy of the malleus that makes it a morphometrically uniform and stable bone.

Lesão oculta da articulação manúbrio-esternal associada à fratura da coluna torácica / Occult manubriosternal joint injury associated with fracture of the thoracic spine

Os autores relatam a ocorrência de lesão oculta da articulação manúbrio-esternal na avaliação inicial de um paciente com fratura da coluna torácica (T9). Foi diagnosticada fratura de T9 no paciente do sexo masculino de 37 anos de idade associada a déficit neurológico parcial. No atendimento inicial, as radiografias realizadas não demonstraram a lesão da articulação manúbrioesternal. Durante a reabilitação, após a estabilização cirúrgica da fratura da coluna torácica, subitamente o paciente sentiu dor intensa, acompanhada de deformidade ao nível do esterno, tendo sido diagnosticada luxação manúbrio-esternal nos exames de imagem. Devido à recidiva da luxação e de dor incapacitante, foi necessária a realização da redução aberta e fixação da articulação manúbrio-esternal. Na avaliação após 12 meses, o paciente apresentou recuperação completa da lesão neurológica, consolidação da artrodese do segmento vertebral T7-T11, e manutenção da redução da articulação manúbrio-esternal, que era assintomática durante a realização das atividades cotidianas.

The authors report the occurrence of an occult manubriosternal joint injury in the initial evaluation on a patient with a thoracic spine fracture (T9). This T9 fracture was diagnosed in a 37-year-old man and was associated with a partial neurological deficit. At the initial evaluation, the radiographs produced did not show the manubriosternal joint injury. During rehabilitation, after surgical stabilization of the thoracic spine fracture, the patient suddenly felt an intense pain accompanied by deformation at the sternal level. From imaging examinations, manubriosternal dislocation was diagnosed. Because of recurrence of the dislocation and the incapacitating pain, open reduction and fixation of the manubriosternal joint had to be performed. At the 12-month follow-up, the patient presented complete recovery of the neurological lesion, consolidation of the arthrodesis on the T7-T11 vertebral segment and maintenance of the reduction of the manubriosternal joint, which was asymptomatic during daily activities.

Study of the operative approach of the upper thoracic vertebrae (report of 21 cases) / 中国矫形外科杂志

[Objective] To investigate the anatomical relation between manubrium sternum incisure(MSI)with the level of upper thoracic vertebrae(UTV)and to find out the basis of operative approach of UTV.[Method]Standing pan chest radiographs of 400 male and 400 female were equally divided into 4 year groups:≤19 years,20～39 years,40～59 years and ≥60 years and were used to observe the relationship between MSI with the level of UTV.On the basis of this relationship,a suitable UTV approach was advocated.There were fracture and dislocation of UTV 7 cases,UTV tumor 9 cases,tuberculosis of UTV 3 cases;OPLL ossification of UTV 2 cases.Diseases located at T1 6 cases,T2 7 cases,T3 2 cases,T4 3 cases,T1、2 2 cases,T2、3 1 case.Lower anterior cervical approach was performed for 7 cases including T1、2 one case and T2 one case,improved T3 1 case,and right subscapular transthoracic posterolateral approach was used for 5 cases.[Result]The number of UTV in relationship with the level of MSI was successively increased from T1 to T3 and was gradually decreased on T4,i.e.rate of cases of level of MST in relationship with T1、2 level was 1%,to T2 level 5.5%,to T2、3 level 15.87%,to T3 level 43.5%,to T3、4 level 20.75%,to T4 13.375%.No relationship was found in trend of distribution with the age and gender.The operative approach of UTV according its relationship with MSI was performed with the advantages of satisfactory exposure easily manipulation and satisfactory clinic results in most follow-up cases.One case died of metastasis of tumor in 9 months,3 cases were complicated with cerebrospinal fluid leakage and 3 cases with injury of recurrent laryngeal nerve.[Conclusion]Approach to UTV should be selected according to its relationship between MSI and diseased UTV preoperatively.The operative approach of UTV according to its relationship with MST has the advantages of satisfactory exposure,easily manipulation and satisfactory clinic results.

Angiosarcoma of Manubrium Sterni

A rare case of angiosarcoma affecting the manubrium sterni is being reported.Angiosarcoma is a very rare tumour affecting the bones with incidence as less as O.13%and its incidence involving the manubrium sternii is extremely rare.