Metopic suture

Last revised by Dr Yuranga Weerakkody on 23 Feb 2021

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.

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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