Introduction: Determination of age is prerequisite for personal identification in living as well as dead. Age estimation becomes a valuable tool to assist in administration of many civil and criminal procedure codes in deciding the age of majority. Questions of juvenility are often a question that has to be answered correctly in connection with criminals of younger age group in cases where biological study of maturity of a child has to be performed to access the development of a child, age estimation is of paramount importance. Material and Methods The present study was carried out on 217 healthy students (101 males&50 females) in Haryana region. The subjects aged between 13-20 year of age of school going children and also of college, were subjected to radiological examination of both hand and with wrist- in AP view and stages of epiphysis fusion was noted. Result & Conclusion Average age of fusion of the base of the first metacarpals complete in 15-16 years in females and 18-19 years in males. Epiphysis fusion was earlier in females as compared to males and it was simultaneously on both sides.
Age estimation is a vital aspect of the process of identification. Studying the appearance and fusion of long bones is one of the most commonly used methods for age estimation. Most research conducted on age estimation using the study of the appearance and fusion of ossification centres has been roentgenographic in nature.(1) Age estimation is a crucial component of human identification in forensic science. It has a vital role in forensic anthropology, including examinations of skeletal remains, disaster victim identification, and locating missing individuals. Present communication focuses on the age estimation through the examination of ossification centers of bones and its significance in identifying the age of 18 years old, a recognized age of majority in many countries.(2) The carpus and the hand are the most studied anatomical region for the diagnosis of age, particularly before the completion of 18 years of age.(3)Various studies conducted in and outside India for estimation of age from long bone joints revealed that unlike other vital parameters no uniform pattern exists for epiphyseal union of long bones indifferent countries of the world and also in different parts of the same country.(4).Thus the present study has been conducted in the Haryana region for assessing the age , by studying the epiphysis fusion of the base of the first metacarpal
This study was carried out in the department of Forensic Medicine and Radio-diagnosis at ,Post Graduate Institute of Medical Sciences, Rohtak in Haryana. The study consisted of 217 subjects between the age of 13 and 20 years from the Haryana region. It included 101 males and 116 females. Source of subjects were from a nearby schools and the para medical courses. The age was verified by checking the date of birth from school admission records. Subjects were made to wear the lead apron,and then seated on a stool of convenient height. X-rays of bilateral wrist joint, including hands were taken in antero-posterior view. The students are divided in seven groups according to the age. i.e. 13 -14 years; 14 -15 years; 15 -16 years; 16 -17 years; 17 -18 Years; 18-19 years; 19-20 years;
The films were studied radiologically by interpreting it into three stages as follows:
The average age of epiphyseal fusion was taken as the youngest age group in which75% of cases showed complete fusion. The range of epiphyseal fusion was fixed from the lower age limit which showed minimum 50 % cases of complete fusion and upper age limit which showed 100% complete fusion.
Age and Sex wise Distribution of subjects
|
Age group (years) |
SEX |
Total |
|
|
Male |
Female |
||
|
13-14 |
11 |
21 |
32 |
|
14-15 |
15 |
14 |
29 |
|
15-16 |
10 |
23 |
33 |
|
16-17 |
25 |
16 |
41 |
|
17-18 |
19 |
18 |
37 |
|
18-19 |
10 |
14 |
24 |
|
19-20 |
11 |
10 |
21 |
|
Total |
101 |
116 |
217 |
The average age of epiphyseal fusion was taken as the youngest age group in which 75% of cases showed complete fusion. The range of epiphyseal fusion was fixed from the lower age limit which showed minimum 50 % cases of complete fusion and upper age limit which showed 100% complete fusion.
|
Age group |
Male |
Female |
P value |
|||||||
|
N(%) |
P(%) |
C(%) |
T(%) |
N(%) |
P(%) |
C(%) |
T(%) |
|||
|
13-14 |
Right |
11(100) |
0(0) |
0(0) |
11(100)
|
21(100) |
0(0) |
0(0) |
21(100)
|
NA |
|
Left |
11(100) |
0(0) |
0(0) |
21(100) |
0(0) |
0(0) |
||||
|
14-15 |
Right |
15(100) |
0(0) |
0(0) |
15(100)
|
4(28.5) |
6(42.9) |
4(28.5) |
14(100)
|
0.001 |
|
Left |
15(100) |
0(0) |
0(0) |
4(28.5) |
6(42.9) |
4(28.5) |
||||
|
15-16 |
Right |
9(90) |
1(10) |
0(0) |
10(100)
|
0(0) |
4(17.4) |
19(82.6) |
23(100)
|
0.001 |
|
Left |
9(10) |
1(10) |
0(0) |
0(0) |
4(17.4) |
19(82.6) |
||||
|
16-17 |
Right |
14(56) |
9(36) |
2(8) |
25(100)
|
0(0) |
0(0) |
16(100) |
16(100)
|
0.001 |
|
Left |
14(56) |
9(36) |
2(8) |
0(0) |
0(0) |
16(100) |
||||
|
17-18 |
Right |
3(15.8) |
5(26.3) |
11(57.9) |
19(100)
|
0(0) |
0(0) |
18(100) |
18(100)
|
0.001 |
|
Left |
3(15.8) |
5(26.3) |
11(57.9) |
0(0) |
0(0) |
18(100) |
||||
|
18-19 |
Right |
0(0) |
0(0) |
10(100) |
10(100)
|
0(0) |
0(0) |
14(100) |
14(100)
|
NA |
|
Left |
0(0) |
0(0) |
10(100) |
0(0) |
0(0) |
14(100) |
||||
|
19-20 |
Right |
0(0) |
0(0) |
11(100) |
11(100)
|
0(0) |
0(0) |
10(100) |
10(100)
|
NA |
|
Left |
0(0) |
0(0) |
11(100) |
0(0) |
0(0) |
10(100) |
||||
The observation of the epiphyseal fusion of base of first metacarpal to the shaft are shown in table for all the age groups separately for males and females.
he p value is less than 0.05 and therefore there is significant difference between the epiphyseal fusion of base of first metacarpal to the shaft in males and females in the mentioned age group.
Observation in males: Average age of epiphyseal fusion was: 18-19, Range of Fusion was:17-19
Observation in females:Average age of epiphyseal fusion was: 15-16 Range of Fusion was:15-17
Wrist with first metacarpal joint showing no fusion
Wrist with first metacarpal joint showing in process of fusion
Wrist with first metacarpal joint showing complete fusion
The hand (including the wrist) has received most attention in the literature, both because it is easy to radiograph, and because it includes a wide range of bones suitable for study.(5) In hand, the metacarpals(MC) are numbered MC 1 (the thumb) through MC 5 (the little finger) The first metacarpal is the shortest metacarpal, broader and more robust in its shaft. The epiphyses for the metacarpals occur at their distal ends with the exception of that at the first which is at the proximal end.(6) Bones in human body begins as a cartilaginous structure, developing and ossifying throughout the period of physical growth, ultimately forming the adult bone structure. Ossification of the various bone centers finishes at different ages. They become radio-opaque on radiographs and change significantly at different skeletal development stages. This staging is the basis for various bone age assessment.(7 ) In the present study of 217, consisting of 101 boys and 116 girls with almost equal distribution of cases in both boys and girls. As per Table 3, which shows comparison of various studies that have been carried out for estimation of age by epiphysis fusion of base of the First Metacarpal.
Comparative study of fusion of base of 1st metacarpal bone
|
Sl .No. |
Research Worker |
Population studied |
Age in years |
|
|
Male |
Females |
|||
|
1. |
Flecker (7)(1932) |
Australian |
17 |
15 |
|
2. |
Paterson(8) (1929) |
Manchester |
19 |
17 |
|
3. |
JOSEPH(9)(1951) |
European |
15-17 |
13-15 |
|
4. |
Galastun(10) (1937)) |
Bengal |
-- |
14-16 |
|
|
Bhise (11) (2011) |
Mumbai |
17-18 |
16-17 |
|
5. |
Kadam(12) (2012) |
Central Karnatka |
16-17 |
15-16 |
|
6. |
Prasad R(13) (2013) |
North Hill area (India) |
17-18 |
|
|
7. |
Shanmugasundaram S (14) (2014) |
Tamil Nadu |
17 |
17 |
|
8. |
Kumar A (15) (2015) |
Delhi |
16-17 |
16-17 |
|
9. |
Singh OG (16) (2016) |
Tamil Nadu |
17 |
17 |
|
10. |
Naik MS (17)(2018) |
Andhrapardesh |
16-17 |
15-16 |
|
11. |
Abhilasha M(18) (2019) |
Rajasthan |
17-18 |
16-17 |
|
12. |
Present Study |
Haryana |
18-19 |
15-16 |
The complete diaphyseo epiphyseal union at the base of Metacarpal was observed in the age group of 18 – 19 years for males, and 15-16 years for females. The union at the base of Metacarpal was observed earlier in females as compared to males. We can conclude that the X-ray of wrist with extended hand can be very useful to estimate age in the age group of 16 years to19 years in the Indian population.
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