Assessment of Age From Sternal Fusion: A Radiographic Autopsy-Based Study in North India

Area of Science:

• Forensic anthropology
• Osteology
• Radiology

Background:

• Age estimation is critical in forensic identification, particularly for fragmented remains.
• The sternum offers a potentially valuable bone for age assessment due to its frequent retrieval.
• Understanding sternum fusion patterns can enhance forensic age determination methods.

Purpose of the Study:

• To estimate the fusion age of manubrio-sternal (M-S) and sterno-xiphoidal (S-X) junctions in the North Indian population.
• To evaluate the utility of sternum fusion in radiographic (X-ray) forensic age estimation for males and females aged 14 and above.
• To investigate sex-specific differences in sternum fusion patterns.

Main Methods:

• Autopsy-based study on 195 sterna (165 males, 30 females) from medico-legal autopsies.
• Radiographic (X-ray) examination to assess M-S and S-X junction fusion status (fused or unfused).
• Correlation analysis (Cramer's V) and Receiver Operating Characteristic (ROC) analysis to assess age estimation accuracy.

Main Results:

• M-S junction fusion observed in 23.6% of cases; S-X junction fusion in 34.4%.
• Earliest fusion at both junctions: 19 years (males), 40 years (females).
• Moderate association between M-S fusion and age in females (ROC: 100% sensitivity, 71% specificity at 40 years).
• Moderate association between S-X fusion and age in males (ROC: 81% sensitivity, 57% specificity at 34 years).
• No significant association for M-S fusion in males or S-X fusion in females.

Conclusions:

• M-S junction fusion may be a useful indicator for age estimation in females.
• S-X junction fusion could serve as a potential age marker in males.
• Further research with larger, balanced samples is recommended due to observed variability and limitations.