Metopic suture

Last revised by Benjamin Li Shun Chan on 4 Jun 2023

The metopic suture (also known as the frontal, interfrontal, or median frontal suture) is a vertical fibrous joint that divides the two halves of the frontal bone and is present in a newborn.

Persistent metopic sutures can be misdiagnosed as vertical skull fractures, therefore it is important to be aware of this anatomical variant.

This suture runs through the midline across the frontal bone from the nasion to the bregma, although it may often be incomplete. It may fuse as early as 3 months of age and should fuse in nearly all patients by around 9 months of age 1-4

Premature fusion of the suture is termed metopic synostosis (type of craniosynostosis) which can then result in trigonocephaly

The metopic suture is usually obliterated by about 7 years of age, but in rare cases, it can persist 6 as an anatomical variant of little clinical significance but that it can be mistaken for a frontal bone fracture.  Persistence of the metopic suture may be associated with frontal sinus agenesis or hypoplasia 7

  • frontal bone fracture

    • metopic sutures have a characteristic midline position and demonstrate sutural interdigitations 4

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Cases and figures

  • Case 1: metopic suture
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  • Case 2: persistent metopic suture
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  • Case 3: with right frontal sinus aplasia
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  • Case 4
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  • Case 5
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  • Case 6: persistent metopic suture with frontal sinus agenesis
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  • Case 7: persistent metopic suture
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  • Case 8: persistent metopic suture
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