Investigating the reliability and sex differences of digit lengths, ratios, and hand measures in infants
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Updated: Nov 4, 2025

Assessment of Child Anthropometry in a Large Epidemiologic Study
Published on: February 2, 2017
Luisa Ernsten1, Lisa M Körner2, Martin Heil2
1Department of Experimental Psychology, Heinrich-Heine-University, Universitätsstraße 1, 40225, Düsseldorf, Germany. Luisa.Ernsten@hhu.de.
Insights
Sex differences in hand and digit measurements are evident in infants, with boys having longer digits and hands but smaller digit ratios. These findings suggest factors beyond prenatal androgens contribute to sexual dimorphism in early development.
Area of Science:
- Anthropology
- Pediatrics
- Human Biology
Background:
- Sexual dimorphism in hands and digits is often linked to prenatal androgen exposure.
- Existing research on prepubertal cohorts shows inconsistent findings and methodological limitations.
- There is a need for standardized measurements in young children to clarify sex differences.
Purpose of the Study:
- To compare the reliability and sex differences of various hand and digit measurements in 6-month-old infants.
- To investigate digit lengths, ratios, relative lengths, asymmetry, and hand dimensions.
- To assess the influence of prenatal factors on these physical traits.
Main Methods:
- Utilized indirect and computer-assisted measurements for 399 male and 364 female German infants.
- Assessed digit lengths (2D, 3D, 4D, 5D), digit ratios (e.g., 2D:4D), relative digit lengths, and hand dimensions (width, length).
- Evaluated inter-examiner and test-retest reliability of the measurement techniques.
Main Results:
- Excellent inter-examiner reliability and moderate to high test-retest reliability were observed.
- Boys displayed significantly longer digits and larger hands (width, length) compared to girls.
- Girls exhibited smaller digit ratios, particularly those involving the fifth digit, indicating significant sex differences.
Conclusions:
- Hand and digit measurements show clear sexual dimorphism in 6-month-old infants.
- While digit ratios involving the fifth digit show the largest effect sizes, other ratios also indicate sex differences.
- The study suggests that factors other than prenatal androgens may contribute to observed sexual dimorphism in early childhood hand and digit morphology.
Abstract:
Hands and digits tend to be sexually dimorphic and may reflect prenatal androgen exposure. In the past years, the literature introduced several hand and digit measures, but there is a lack of studies in prepubertal cohorts. The available literature reports more heterogeneous findings in prepubertal compared to postpubertal cohorts. The comparability of the available studies is further limited by the study design and different measurement techniques. The present study compared the reliability and sex differences of available hand and digit measures, namely digit lengths of 2D, 3D, 4D, 5D, digit ratios 2D:4D, 2D:5D, 3D:4D, 3D:5D, 4D:5D, relative digit lengths rel2, rel3, rel4, rel5, directional asymmetry of right and left 2D:4D (Dr-l), hand width, length, and index of 399 male and 364 female 6-month-old German infants within one study using only indirect and computer-assisted measurements. The inter-examiner reliability was excellent while the test-retest reliability of hand scans was only moderate to high. Boys exhibited longer digits as well as wider and longer hands than girls, but smaller digit ratios, with ratios comprising the fifth digit revealing the largest effect sizes. Other hand and digit ratios revealed sex differences to some extent. The findings promote the assumption of sexual dimorphic hand and digit measures. However, by comparing the results of the available literature, there remains an uncertainty regarding the underlying hypothesis. Specifically in prepubertal cohorts, i.e. before the influence of fluctuating hormones, significant effects should be expected. It seems like other factors than the influence of prenatal androgens contribute to the sexual dimorphism in hand and digit lengths.
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