Indian Journal of Basic and Applied Medical Research; September 2014: Vol.-3, Issue- 4, P. 42-45
Original article Metopic suture and its variations Dr. T. H. Dilip Kumar, Dr. S. S. Rajasekar
Department of Anatomy, Sri Manakula Vinayagar Medical College and Hospital, Kalitheerthalkuppam, Madhagadipet Corresponding author: Dr. T. H. Dilip Kumar Date of submission: 12 May 2014 ; Date of Publication: 15 September 2014
Abstract: Introduction : Metopic suture is defined as a condition in which two pieces of frontal bone fail to merge in early childhood. Complete metopic suture extends from nasion to bregma and incomplete metopic suture present at the glabella of skull. It may be misdiagnosed as vertical traumatic skull fracture. Methods : This study was conducted in 50 skulls from the Department of Anatomy, Sri Manakula Vinayagar Medical College and Hospital, Pondicherry. Skulls with signs of disease and damaged skulls were excluded from the study. Metopic sutures are divided into three groups Absent, Complete and Incomplete sutures. Results : Complete metopic suture were present in 2% (1/50), Incomplete metopic suture were present in 44 %( 22/50) and Absent in 54 %( 27/50). Conclusion: The persistence of metopic suture in adults which separates the frontal bones are important in assessing the radiological images and in evaluation of medico legal cases. Keywords: Metopic suture, vertical fracture
Introduction: Frontal bone is a curved plate of pneumatic bone 1. Metopic suture is formed between the tubers of frontal bone. Usually it is closed by the intramembranous ossification from the inner face of skull. The closure occurs from the two primary centres from each half of the frontal 2 bone . There are two types; complete and incomplete Metopic sutures. Complete Metopic Figure 1: showing normal appearance suture is from nasion to bregma. Incomplete Metopic suture starts from nasion but does not reach till bregma 3. The incidence of metopism may vary by race 4. Usually Metopic suture will start to close from the age of 18 months by the end of 8 – 9 years it gets completely fused, persistent of this suture results in metopism8.
Figure 2: showing complete metopic suture
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Indian Journal of Basic and Applied Medical Research; September 2014: Vol.-3, Issue- 4, P. 42-45
Materials and methods: Results: This study was conducted on 50 skulls from Complete Metopic suture were present in 2 % the Department of Anatomy , Sri Manakula (1/50). Incomplete Metopic suture were present Vinayagar Medical College and Hospital, in 44% ( 22/50) and absent in 54% (27/50). Pondicherry. Skulls with signs of disease and Out of 22 incomplete metopic sutures, Single linear damaged skulls were excluded from the study. Metopic suture were present in 9/22 (40.9 %). They were divided into three groups Absent, Double linear Metopic suture were present in 6/22 complete and incomplete Metopic sutures. (27.2%). V- shaped Metopic suture were present in 4/22 (18.2%), U shaped Metopic suture were present in 3 / 22 (13.7%). S.NO METOPIC SUTURE NUMBER PERCENTAGE (%) 1. ABSENT 27 / 50 54 % 2. COMPLETE 1 / 50 2 % 3. INCOMPLETE 22 / 50 44 % 3 A SINGLE LINEAR 9 / 22 40.9 % 3 B DOUBLE LINEAR 6 / 22 27.2 % 3 C V – SHAPED 4 / 22 18.2 % 3 D U – SHAPED 3 / 22 13.7 % Table 1: showing results in percentages Discussion Indians - 3 % 9 . Chandrasekaran et al at 1985 Metopic suture is an dentate suture extending conducted this study on South Indians – 3 % 10 . from nasion to bregma. According to Del Sol et Compared to other studies the incidence of al the causative factors Metopic suture are : Metopic suture in South Indian population is abnormal growth of cranial bones, 2- 3 % as seen in the present study as well as hydrocephalus, growth retardation, Atavism, other literature. Stenocratophia (abnormal narrowing of temporal Conclusion: area of the head), Plagiocephaly ( cranial The knowledge about the Metopic suture is malformation causing a twisted and very important for radiologist, orthopaedic asymmetrical head because of Synostosis of Surgeons, Oromaxillofacial Surgeons, cranial sutures), Scaphocephaly (deformed head neurosurgeons in daily practice . Since this projecting forward like keel of boat ).It is suture resembles an vertical fracture of the commonly seen in Apert syndrome 5. frontal bone. The incidence of complete Metopic suture from other studies are as follows : Bryces et al at 1915 conducted this study in different races , European – 8.5%, Mongolism – 5.5%, Negros – 1.2% 6. Woo et al at 1945 conducted this study in Mongoloid race – 10 % 7. Romanes et al at 1972 conducted this study on European race – 8 % 8. Das et al at 1973 conducted this study on 43 www.ijbamr.com P ISSN: 2250-284X , E ISSN : 2250-2858
Indian Journal of Basic and Applied Medical Research; September 2014: Vol.-3, Issue- 4, P. 42-45
Figure 3: showing Single linear type of suture Figure 5: showing V – shaped suture
Figure 4: showing double linear type of suture Figure 6: showing U – shaped suture
References: 1. Chakravarthi KK, Venumadhav N. Morphological study of Metopic suture in adult South Indian skulls. Int J Med Health Sci 2012;1(2):23-8. 2. Castilho MA, Oda JY, Gonçales DM. Metopism in Adult Skulls from Southern Brazil. Int. J. Morphol 2006;24(1):61-6. 3. Yadav A, Kumar V, Srivastava RK. Study of Metopic suture in the adult human skulls of north India. J. Anat. Soc. India 2010;59(2):232-6. 4. Bademci G, Kendi T, Agalar F. Persistent Metopic suture can mimic the skull fractures in the emergency setting? Neurocirugia 2007;18(1):238-40. 5. Del Sol, Binvignat, Bolini, Prates. Metopismo no individuo brasileiro. Rev. Paul. Med 1989;107(2):105-7. 6. Bryce TH. Osteology and anthropology in Quain elements of anatomy.11th ed. Vol 4, London, 1915, 177. 7. Woo, Ju-Kang. Racial and sexual difference in the frontal curvature and its relation to metopism. A.J.P.A.1949; l 7(2); 215-26. 8. Romanes GJ. Cunningham’Textbook of Anatomy. 11th Ed. Oxford University, London,1972;133.
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9. Das AC, Saxena RC, Beg MA. Incidence of metopic suture in U P Subject. J of Anat. Soc. Of India,1973; 22: 4l. 10. Chandrasekhran P. Identification of skull from its suture pattern. Forensic science International. 1985; 27:205-14.
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