In Vivo Morphology of the Sternum with Emphasis on the Frequency of Sternal Foramen

Objective To determine the incidence and morphology of the foramen in the sternum and to investigate the connection between the foramen and the types of xiphoid process terminations. Materials and Methods A total of 1600 subjects over the age of 18 were evaluated retrospectively with three-dimensional bone configuration from computed tomography. The localization, morphology of the sternal foramen, and types of xiphoid process terminations were investigated. Results A sternal foramen was found in 127 subjects, with 74 (58.3%) located in the corpus and 53 (41.7%) in the xiphoid process. The xiphoid process termination types were as follows: single in 87 subjects (68.5%), double-ended in 34 subjects (26.8%), and triple-ended in 6 subjects (4.7%). No statistically significant correlation was found between xiphoid process termination type and foramen localization (p = 0.92, p > 0.05). Conclusion The sternal foramen is of clinical important due to the important vital structures such as pericardium and pleura located posteriorly. Due to the high incidence of the sternal foramen and its morphologically large area, preliminary screening must be performed before clinical applications to the region. In addition, the sternal foramen is an important embryological variation that should be taken into consideration in terms of forensic medicine research and medical education.