The metopic suture is the midline fibrous joint between the two halves of the frontal bone, running from the nasion up to bregma. It is the first cranial suture to close, normally fusing in infancy so that the adult frontal bone is a single piece. In a minority of adults it stays open, a harmless variant called metopism.
| Articulations | |
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| Landmarks |
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| Ossification | The frontal bone develops in membrane from two centres, one on each side; the metopic suture between them normally fuses within the first year of life, commonly by about 9 months, though it persists into adulthood in a small percentage of people. |
Metopic craniosynostosis produces trigonocephaly, a triangular forehead with a midline keel and close-set eyes, and is now the second or third most common synostosis in many series. A mild palpable metopic ridge with a normal forehead shape is common and needs no treatment. A persistent metopic suture in an adult can be mistaken for a frontal bone fracture on X-ray or CT, so radiologists should recognise it as a normal variant.
Premature fusion of the metopic suture causing a triangular, pointed forehead and narrow eye spacing; severe cases are corrected by fronto-orbital advancement surgery.
A persistent metopic suture in an adult can be misread as a midline frontal fracture after head injury; its smooth, symmetrical course from nasion to bregma identifies it as normal.
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