Quantification of Sternum Morphomics and Injury Data 2019-01-1217

Crash safety researchers have an increased concern regarding the decreased thoracic deflection and the contributing injury causation factors among the elderly population. Sternum fractures are categorized as moderate severity injuries, but can have long term effects depending on the fragility and frailty of the occupant. Current research has provided detail on rib morphology, but very little information on sternum morphology, sternum fracture locations, and mechanisms of injury. The objective of this study is two-fold (1) quantify sternum morphology and (2) document sternum fracture locations using computed tomography (CT) scans and crash data. Thoracic CT scans from the University of Michigan Hospital database were used to measure thoracic depth, manubriosternal joint, sternum thickness and bone density. The sternum fracture locations and descriptions were extracted from 63 International Center for Automotive Medicine (ICAM) crash cases, of which 22 cases had corresponding CT scans. The University of Michigan Internal Review Board (HUM00043599 and HUM00041441) approved the use of crash cases and CT scan data.

The sternum morphomics data showed the thoracic depth increased, except for the 60-74-year-old age group. The average sternum thickness was greater in the older age groups. The sternum bone density decreased from youngest to oldest age groups. The angle between the manubrium and the sternum body decreased by 5.6° between the youngest and oldest age groups. The frequency of sternum fractures increased after age 45. Fractures were most frequent in the sternum body. The seat belt webbing was coded as the source of 54% of the sternum fractures.