Original Research Paper Age Determination From Radiological Study of Epiphysial Appearance and Union Around Wrist Joint and Hand
Original Research Paper Age Determination From Radiological Study of Epiphysial Appearance and Union Around Wrist Joint and Hand
Original Research Paper Age Determination From Radiological Study of Epiphysial Appearance and Union Around Wrist Joint and Hand
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J Indian Acad Forensic Med. October- December 2011, Vol. 33, No. 4 ISSN 0971-0973
Stage 3(F3): Incomplete union – when the seen. Pisiform is not appeared below 13 years of
epiphysis has begun to fuse with shaft and age (34.15%) where as in age group 12-13 and
complete union was well underway (1/2 united) above (66.85%) its appearance is seen.
Stage 4(F4): Complete union – when the Trapezium is not appeared below 6 years of age
epiphysial cartilage was bony in architecture and (10.73%) where as in age group 5-6 and above
its density indistinguishable from the epiphysis (89.27%) its appearance is seen. Trapezoid is
and diaphysis in its neighbourhood but an not appeared below 6 years of age (2.92%)
epiphysial line called epiphysial scar could still where as in age group 5-6 and above (97.07%)
be distinguished. (3/4 united) its appearance is seen.
Stage 5(F5): Complete union – with absence of In female subjects below 7 years of age
epiphysial scar. (15.96%) scaphoid is not appeared where as in
Skeletal maturity was evaluated age group 6-7 and above (84.04%) its
radiologically studying the various centres of appearance is seen. Lunate is not appeared
ossification and the results were compared with below 5 years of age (8.51%) where as in age
the previous known standard studies. Only group 5-6 and above (91.49%) its appearance is
appearance and last two stage of fusion cases seen. Pisiform is not appeared below 12 years of
were taken in this paper, remaining cases were age (35.11%) where as in age group 10-11 and
in early stages of fusion above (64.89%) its appearance is seen.
Results and observations: Trapezium is not appeared below 6 years of age
Fusion of distal end of radius: It is clear from (9.57%) where as in age group 5-6 and above
table-1 that in male subjects in majority of cases (90.43%) its appearance is seen. Trapezoid is
in age group 15-16 and 16-17 show near fusion not appeared below 5 years of age (5.32%)
(F4), where as in age groups17-18 and onwards where as in age group 4-5 and above (94.68%)
majority of cases showed fusion (F5) its appearance is seen.
st
It is clear from table-2 that in female subjects Fusion of base of 1 metacarpal: It is clear
in majority of cases in age group 15-16 and 16- from table-6 that in male subjects in majority of
17 show near fusion (F4), where as in age cases in age group 15-16, 16-17, and 17-18
groups17-18 and onwards majority of cases show near fusion (F4), where as in age
showed fusion (F5) groups16-17, 17-18 and onwards majority of
Appearance of distal end of ulna: It is clear cases showed complete fusion (F5)
from table-3 that in male subject in majority of It is clear from table-6 that in female
cases in age group 7-8 and 8-9 does not show subjects in majority of cases in age group 14-15,
appearance of distal end of ulna. The 15-16, and 16-17 show near fusion (F4), where
appearance of ulna is seen in age group 9-10, as in age groups15-16, 16-17 and onwards
10-11, 11-12 in male majority of cases showed complete fusion (F5)
It is clear from table-3 that in female Fusion of phalanges in males: It is clear from
subject in majority of cases in age group 6-7 and table-7 that in male subjects for proximal row of
7-8 does not show appearance of distal end of phalanges in majority of cases in age group 15-
ulna. The appearance of distal end of ulna is 16, 16-17, and 17-18 show near fusion (F4),
seen in age group 8-9, 9-10, 10-11 in females where as in age groups16-17, 17-18 and
Fusion of distal end of ulna: It is clear from onwards majority of cases showed complete
table-4 that in male subjects in majority of cases fusion (F5). for middle row of phalanges in
in age group 16-17 and 17-18 show near fusion majority of cases in age group 15-16, 16-17, and
(F4), where as in age groups17-18, 18-19 and 17-18 show near fusion (F4), where as in age
onwards majority of cases complete showed groups16-17, 17-18 and onwards majority of
fusion (F5). cases showed complete fusion (F5). for terminal
It is clear from table-5 that in female row of phalanges in majority of cases in age
subjects in majority of cases in age group 15-16 group 15-16, 16-17, and 17-18 show near fusion
and 16-17 show near fusion (F4), where as in (F4), where as in age groups16-17, 17-18 and
age groups16-17, 17-18 and onwards majority of onwards majority of cases showed complete
cases complete showed fusion (F5). fusion (F5).
Carpel bones appearance in both males and Fusion of phalanges in females: It is clear
females: In male subjects below 8 years of age from table-8 that in female subjects for proximal
(13.66%) scaphoid is not appeared where as in row of phalanges in majority of cases in age
age group 7-8 and above (86.34%) its group 14-15, 15-16, and 16-17 show near fusion
appearance is seen. Lunate is not appeared (F4), where as in age groups 15-16, 16-17 and
below 6 years of age (6.345) where as in age onwards majority of cases showed complete
group 5-6 and above (93.66%) its appearance is fusion (F5). for middle row of phalanges in
majority of cases in age group 13-14 and 14-15
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J Indian Acad Forensic Med. October- December 2011, Vol. 33, No. 4 ISSN 0971-0973
show near fusion (F4), where as in age 6.Hepworth SM. Determination of age in Indians from study of
ossification of long bones Ind. Med. Gaz., 64,128,1929
groups15-16 and onwards majority of cases 7.Basu SK and Basu S: A contribution to the study of
showed complete fusion (F5). for terminal row of diaphysiopiphysial reletion at elbow of young Bangalee girls.
phalanges in majority of cases in age group 14- Indian journal of Paediatrics, 5, 202-204, 1938.
15, and 16-17 show near fusion (F4), where as
in age groups15-16, 16-17 and onwards majority
of cases showed complete fusion (F5).
Discussion:
The documented study done previously
in Mumbai region was by Homi S. Mehta is
available for standard comparison in Mumbai
region. Observation of present study correlates
with Homi S Mehta for females at the centres of
distal end of radius, ulna. At wrist, the complete
union of epiphysis is seen by 18 - 19 years in
males and 16 - 17 years in females. As b) Dist. end of radius in F1
compared to Flecker‘s study in Australians and stage. Dist. E/O ulna not
Dist. end radius appeared. Dist. appeared (4yr/m)
Davies and Parsons Study in England end ulna not appeared (1yr/m)
ossification center appearance and fusion
occurs one to two years earlier in this study.
The present study signifies that all
centres in females mature 1-2 years earlier than
in Males. These observations correlate with the
previous studies. Comparison of observations of
present study has been made with other workers
with reference to age of fusion in both sexes.
(Table 9)
Conclusions: D) Dist. E/O radius in F2
Apart from consideration of centers of c) Dist E/O radius in F2 stage. Dist stage. Dist E/O ulna in F1
E/O Ulna appeared (9yr/m) stage (10yr/m).
ossification by Dr. Homi S Mehta for population
of Mumbai region additional centers of
ossification have been studied in this study
which will be helpful to arrive at correct
diagnosis with closer range.
As compared to Bengali Hindu female‘s
ossification center fusion occurs one to two year
later in Mumbai region females. As compared to
Hepworth study in Panjabi region skeletal
maturity is delayed by 6 months to 1 year in
Mumbai region. As this study is done in Mumbai
region the application of standards can be
considered ideal for application in Mumbai E) Both Dist. E/O. Radius & ulna F) Both Dist. E/O. Radius &
region. Due to very narrow borderline range of in F3 stage. (14yr/m) ulna in F4 stage. (17yr/m)
differentiation between various stages of fusion
(i.e. Stage 1 to Stage 5), it is difficult to consider
stage of fusion as age indicator.
References:
1.Homi S Mehta: Medical Law and Ethics in India 1st edi. March
1963, p 336 - 339
2.R.N. Karmakar, J.B. MUkharjees Essential of forensic Medicine
and toxicology 3rd edi. p 126, 146, 147, 154, 155
3.V. B. Gaur, V. B. Sahai, Amarjit Singh, Amit Khout.
Determination of age in living by closure of cranial sutures a
radiological study et al journal of IAFM Vol 29 No.1 2007. P
32-34
4.H.Flecker, Roentgenographic observations of the times of
appearance of epiphyses and their fusion with the diaphyses, G) Both Dist. E/O. Radius & ulna in
J. Anat. 67 (1933), pp. 118–164. F5 stage. (18yr/m)
5.Krogman WM, Iscan, MY in The human skeleton in Forensic
Medicine, Charles C.Thomas Publisher, Illinois, USA. II
Edition, 1986.
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