Sternum

"The sternum, a flat bone located in the middle of the chest, forms part of the anterior thoracic wall overlying the heart and great vessels in the middle mediastinum. Its caudal end, the xiphoid process, is related to the central tendon of the diaphragm and inferior border of the heart. Knowledge of the anatomy and variations of the sternum is important during evaluation and treatment of various hematological and developmental diseases, planning thoracic surgery, identifying possible post-surgery complications and preventing mediastinal organ injury such as cardiac tamponade . The sternum is also an important landmark in forensic medicine and anthropology. Variations of the sternal angle are also important during physical examination of the chest, intercostal nerve blocks, insertion of underwater-seal chest drains and bedside measurement of jugular venous pressure . However, these procedures can be markedly influenced by misplaced and impalpable sternal angles . Furthermore, additional symphyses at the manubriosternal junction have been incorrectly labeled as fractures, traumatic fissures and lytic lesions in cross-sectional imaging of the sternum. Radiologists should be aware of these variations as potential differential diagnosis. The sternal angle measures approximately 155° to 175° which confer rigidity to manubriosternal union. However, exaggerated sternal angles have been associated with sternal fractures during minor trauma to the anterior chest wall. These fractures have also been documented during active compression-decompression cardio-pulmonary resuscitation. Such fractures not only increase the likelihood of damage to underlying organs but may also impair ventilation and complicate recovery. These variations of the sternum are rarely reported in the African population and data from Kenya is altogether absent. The current study therefore aimed to determine the prevalence of abnormal sternal angles in a Kenyan population. (Hemed El-Busaidy*, Jameela Hassanali, Wycliffe Kaisha, Saidi Hassan, Julius Ogeng’o and Bernard Ndung’u- Prevalence of Abnormal Sternal Angles in a Kenyan Population)"

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Last date updated on May, 2024