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Pediatric Coronal Suture Fiber Alignment and the Effect of Interdigitation on Coronal Suture Mechanical Properties
Kelly Nicole Adamski1, Andre Matthew Loyd, Albert Samost
1Department of Biomedical Engineering, Injury and Orthopaedic Biomechanics Laboratory, Duke University, Box 90281, Durham, NC, 27708-0281, USA, kelly.adamski@gmail.com.
Insights
Pediatric skull sutures show increased fiber alignment with age, impacting head injury biomechanics. Suture shape predicts ultimate strain but not other mechanical properties in young children.
Area of Science:
- Biomechanical Engineering
- Pediatric Orthopedics
- Craniofacial Development
Background:
- Understanding pediatric head injury biomechanics requires knowledge of skull properties.
- Previous research has not analyzed pediatric cranial suture morphology or linked it to mechanical properties.
Purpose of the Study:
- To quantify pediatric cranial suture geometry.
- To investigate the correlation between suture morphology and mechanical properties in pediatric specimens.
Main Methods:
- Histological analysis quantified suture fiber alignment in neonates, 9-month-olds, 11-month-olds, and 18-month-olds.
- Micro-CT scanning of a 6-year-old's sutures measured interdigitation using sinuosity and surface area indices.
- Mechanical properties were assessed using established methods.
Main Results:
- Histological analysis revealed a significant increase in suture fiber alignment with age (neonatal: 32.2°, 18-month-old: 16.2°, p < 0.0001).
- Suture sinuosity positively correlated with ultimate strain (R² = 0.62, p = 0.011).
- No significant relationships were found between interdigitation measurements and elastic modulus or other mechanical properties.
Conclusions:
- Pediatric cranial sutures exhibit significant developmental changes in fiber alignment during early childhood.
- Suture interdigitation geometry is a limited predictor of mechanical properties, primarily influencing ultimate strain.
Abstract:
The morphological and mechanical properties of the pediatric skull are important in understanding pediatric head injury biomechanics. Although previous studies have analyzed the morphology of cranial sutures, none has done so in pediatric specimens nor have previous studies related the morphology to mechanical properties of human sutures. This study quantified the geometry of pediatric cranial sutures and investigated its correlation with the suture mechanical properties. First, the suture fiber alignment was quantified using histological analysis for four ages-neonate, 9 months-old, 11 months-old, and 18 months-old. For the morphometric investigation of the suture interdigitation, suture samples from a 6-year-old were scanned using micro-CT and the level of interdigitation was measured using two techniques. The first technique, the sinuosity index, was calculated by dividing the suture path along the surface of the skull by the suture distance from beginning to end. The second technique, the surface area interdigitation index, was calculated by measuring the surface area of the bone interface outlining the suture and dividing it by the cross-sectional area of the bone. The mechanical properties were obtained using methods reported in Davis et al.6. The results of the histological analysis showed a significant increase in fiber alignment in older specimen; where random fiber alignment has an average angle deviation of 45°, neonatal suture fibers have an average deviation of 32.2° and the 18-month-old fibers had an average deviation of 16.2° (p < 0.0001). For the suture index measurements, only the sinuosity was positively correlated with the ultimate strain (R (2) = 0.62, Bonferroni corrected p = 0.011) but no other measurements showed a significant relationship, including the amount of interdigitation and elastic modulus. Our results demonstrate that there is a distinct developmental progression of the suture fiber alignment at a young age, but the differences in suture interdigitation can only predict the ultimate strain and no other mechanical properties.
