Weaver Ashley A, Schoell Samantha L, Nguyen Callistus M, Lynch Sarah K, Stitzel Joel D
Virginia Tech-Wake Forest University Center for Injury Biomechanics, Department of Biomedical Engineering, Winston-Salem, North Carolina; Wake Forest University School of Medicine, Department of Biomedical Engineering, Winston-Salem, North Carolina.
J Morphol. 2014 Nov;275(11):1284-99. doi: 10.1002/jmor.20302. Epub 2014 Jun 17.
Age and sex-related variations in sternum morphology may affect the thoracic injury tolerance. Male and female sternum size and shape variation was characterized for ages 0-100 from landmarks collected from 330 computed tomography scans. Homologous landmarks were analyzed using Procrustes superimposition to produce age and sex-specific functions of 3D-sternum morphology representing the combined size and shape variation and the isolated shape variation. Significant changes in the combined size and shape variation and isolated shape variation of the sternum were found to occur with age in both sexes. Sternal size increased from birth through age 30 and retained a similar size for ages 30-100. The manubrium expanded laterally from birth through age 30, becoming wider in relation to the sternal body. In infancy, the manubrium was 1.1-1.2 times the width of the sternal body and this width ratio increased to 1.6-1.8 for adults. The manubrium transformed from a circular shape in infancy to an oval shape in early childhood. The distal sternal body became wider in relation to the proximal sternal body from birth through age 30 and retained this characteristic throughout adulthood. The most dramatic changes in sternum morphology occur in childhood and young adulthood when the sternum is undergoing ossification. The lesser degree of ossification in the pediatric sternum may be partly responsible for the prevalence of thoracic organ injuries as opposed to thoracic skeletal injuries in pediatrics. Sternum fractures make up a larger portion of thoracic injury patterns in adults with fully ossified sternums. The lack of substantial size or shape changes in the sternum from age 30-100 suggests that the increased incidence of sternal fracture seen in the elderly may be due to cortical thickness or bone mineral density changes in the sternum as opposed to morphological changes.
胸骨形态的年龄和性别相关差异可能会影响胸部的损伤耐受性。通过对330例计算机断层扫描收集的地标点，对0至100岁男性和女性的胸骨大小和形状变化进行了表征。使用普洛卡斯特叠加法分析同源地标点，以生成代表组合大小和形状变化以及孤立形状变化的三维胸骨形态的年龄和性别特定函数。发现胸骨的组合大小和形状变化以及孤立形状变化在两性中均随年龄发生显著变化。胸骨大小从出生到30岁增加，在30至100岁时保持相似大小。胸骨柄从出生到30岁向外侧扩展，相对于胸骨体变宽。在婴儿期，胸骨柄的宽度是胸骨体宽度的1.1至1.2倍，而对于成年人，这个宽度比增加到1.6至1.8。胸骨柄在婴儿期从圆形转变为幼儿期的椭圆形。从出生到30岁，胸骨体远端相对于近端胸骨体变宽，并在整个成年期保持这一特征。胸骨形态最显著的变化发生在儿童期和青年期，此时胸骨正在进行骨化。小儿胸骨骨化程度较低可能是小儿胸部器官损伤而非胸部骨骼损伤普遍存在的部分原因。在胸骨完全骨化的成年人中，胸骨骨折在胸部损伤模式中占更大比例。胸骨在30至100岁之间缺乏明显的大小或形状变化，这表明老年人中胸骨骨折发生率增加可能是由于胸骨皮质厚度或骨矿物质密度变化，而非形态学变化。
