The sternum forms the central anterior thorax, articulating with the clavicles at the SC joints and the costal cartilages of ribs 1-7. The manubrium-body junction (sternal angle, angle of Louis) is at the level of the second rib, the primary surface landmark for counting ribs. The xiphoid process is the most inferior and variable component. Median sternotomy for cardiac surgery divides the sternum longitudinally and requires sternal wire fixation for healing.
An expanded entry for Sternum.
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| Landmarks |
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| Ossification | The manubrium ossifies from two centres in the embryonic period. The sternal body segments fuse upward progressively after birth. The xiphoid ossifies at 3 years and fuses to the body in the 40s-50s. The manubriosternal synchondrosis may persist as a joint (symphysis) or calcify with age. |
Sternal wound infection after median sternotomy (post-sternotomy mediastinitis) is a life-threatening complication requiring surgical debridement, vacuum-assisted closure, and pectoral or omental flap reconstruction. Sternal fracture from direct impact (steering wheel in MVA) is associated with cardiac contusion. Cardiac monitoring for 24-48 hours is mandatory.
Usually from seat belt or steering wheel impact; associated with blunt cardiac injury.
A congenital inward depression of the sternum and lower costal cartilages, which may affect appearance and, when severe, heart and lung function.
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