Determinación forense de la edad en individuos vivos / Forensic determination of age in living individuals

ResumenEste artículo es una revisión bibliográfica, sobre la determinación de la edad en individuos vivos, desconocidos e indocumentados, en los que resulta fundamental debido a un proceso legal determinar si son mayores de edad. La estimación de la edad, es un estudio relativamente joven de la medicina forense, que tomó importancia en los años noventa, debido a los movimientos migratorios.

SummaryThis is a bibliographical review, on the determination of the age in alive, unknown and undocumented individuals, in which it is fundamental to determine if they are of age. The estimation of the approximate age, is a relatively young study of the forensic medicine, that took importance in the nineties, due to the migratory movements.

A Histological Study of Postnatal Development of Clavicle Articular Ends / Estudio histológico del desarrollo posnatal de los extremos articulares de la clavícula / Um estudo histológico do desenvolvimento pós-natal das extremidades articulares da clavícula

The clavicle is the first bone to begin the process of ossification and the last one to complete it. Whilst histological studies of the clavicle have been focused mainly on embryonic events, our study focused on postnatal clavicle development. The objective of this study was to perform a qualitative description of the clavicle's epiphyseal growth to further shed light on the postnatal ossification process. Histological studies performed on clavicles obtained from cadavers confirmed medial and lateral extremities as true physes. Unlike the development of other long bones, no secondary ossification centre was present at the acromial end. Furthermore, appearance of the sternal end was observed after the age of 18, as evidenced in clavicles from a 19-year old individual. The articular surface of the clavicle's acromial end was fibrocartilage. Thus far no histological studies have been performed before describing postnatal development of clavicular ends. Our data confirm the absence of an acromial secondary ossification centre, the late development of a secondary ossification centre at the sternal end, and the presence of fibrocartilage at the acromial end.

La clavícula es el primer hueso que comienza el proceso de osificación y el último en completarlo. Mientras los estudios histológicos de la clavícula se han enfocado principalmente en los eventos embrionarios, nuestro estudio se enfoca en su desarrollo posnatal. El objetivo de este estudio fue llevar a cabo una descripción cualitativa del crecimiento epifisario de la clavícula, que pueda arrojar luz sobre el proceso de osificación posnatal. Los estudios histológicos llevados a cabo en clavículas procedentes de cadáveres confirman que las extremidades mediales y laterales son verdaderas fisis. A diferencia del desarrollo de otros huesos largos, no se encuentra otro centro de osificación secundaria en la extremidad acromial. Por otra parte, la aparición de la extremidad esternal ocurre a la edad de 18 años, como se evidenció en clavículas del individuo de 19 años de edad. La superficie articular del extremo acromial de la clavícula era fibrocartilago. No se han realizado hasta ahora estudios histológicos que describan el crecimiento posnatal de las extremidades claviculares. Nuestros datos confirman la ausencia de un centro de osificación secundaria acromial, el desarrollo tardío de un centro de osificación secundaria en la extremidad esternal y la presencia de fibrocartílago en la extremidad acromial.

A clavícula é o primeiro osso a iniciar o processo de ossificação e o último em completar. Enquanto estudos histológicos da clavícula tém sido focados principalmente em eventos embrionarios, nosso estudo enfoca no desenvolvimento pós-natal da clavícula. O objetivo de esse estudo foi realizar uma descreo qualitativa do crescimento epifisário da clavícula para aclarar o processo de ossificação pós-natal. Estudos histológicos realizados em clavículas obtidas de cadáveres confirmaram as extremidades mediais e laterais como fises reais. Diferente do desenvolvimento de outros ossos longos, nenhum centro de ossificação secundário estava presente na extremidade acromial. Além disso, o aparecimiento da extremidade esternal foi observado após os 18 anos, sendo evidenciado em clavículas de indivíduos de 19 anos. A superficie articular da extremidade acromial da clavícula era fibrocartilaginosa. Nenhum estudo histológico havia sido realizado previamente descrevendo o desenvolvimento pós-natal das extremidades claviculares. Nossos dados confirmam a ausencia de um centro de ossificação secundária acromial, o desenvolvimento tardio de centro de ossificação secundário na extremidade esternal, e a presenca de fibrocartilagem na extremidade acromial.

Age estimation from ossification of the medial clavicular epiphysis by computed tomography / Estimación de la edad de osificación de la epífisis medial clavicular por tomografía computadorizada

The current study intended to evaluate the accuracy of age estimation from the development of the medial clavicular epiphysis (sternal end of the clavicle) in Egyptian population using computed tomography (CT) and to develop a discriminant formula that can be used in Egyptians. The study was conducted on 142 subjects (84 males and 58 females) after taken informed consent. They were subjected to multi-slice CT on the medial end of clavicles of both sides. The results revealed that the age of non - union was seen at 8­17 years; incomplete union at 15­20 years and complete union was seen at 20 years. It is concluded that the ossification of medial clavicular end could be used for age estimation. Also CT is a good visualization tool to be used. Regression analysis for each and both clavicles in both sexes is specific to Egyptian population and should be used after validation of the results in other ones. The study recommended using stage 1 to be <17 years; stage 2 to be >15 years; Stage 3 to be >15 years; stage 4 of maturation to be >19 years and stage 5 to be >21 years.

El objetivo de esta investigación fue evaluar en la población egipcia, la exactitud de estimación de edad del desarrollo de la extremidad esternal de la clavícula, mediante tomografía computadorizada (TC), y desarrollar una fórmula discriminante que se pueda utilizar en egipcios. La investigación se realizó en 142 pacientes (84 hombres y 58 mujeres) después de obtener el consentimiento informado. Los pacientes fueron sometidos a TC de cortes múltiples en la extremidad esternal de la clavícula en ambos lados. Los resultados revelaron que la no unión fue observada entre los 8­17 años; la unión incompleta entre 15­20 años y la unión completa a los 20 años. Se concluye que la osificación de la extremidad esternal de la clavícula podría ser utilizada para la estimación de la edad utilizando la TC como herramienta de visualización. El análisis de regresión para ambas clavículas en los dos sexos es específico de la población egipcia y se debe utilizar después de validar los resultados. El estudio recomienda el uso de la etapa 1 en <17 años, etapa 2 en >15 años, etapa 3 en >15 años, etapa 4 en la maduración >19 años y la etapa 5 >21 años.

Study of medial end of fourth ribs with special reference to changes in pit shapes according to age, a qualitative approach.

Background: The objectives of this study were to find changes of pit shape at sternal end of fourth ribs in accordance with age in males, to find bilateral variability in changes of pit shape according to age and to compare the data with previous study. Methods: Total 180 ribs were obtained from male cadavers brought for post-mortem examination. Out of which 140 ribs belonged to 70 cases were included in the study. Each rib was classified according to different stages of pit shape. The data derived were statistically analysed. Results: Pit shape changes from shallow dent to „V‟, from „V‟ to „U‟, from „U‟ to „wide mouth U‟ up to sixties of age and after that the quality of the walls surrounding the pit decreases without changes in shape of pit. There was no any bilateral variation found in pit shape changes for age. Conclusions: Changes of pit shape at sternal end of fourth ribs are age dependent without bilateral variations. Age estimation by this method gives general idea about the age in decades only

The advantage analysis of anterior cervical muscle group approach at sternal end transection in removal of bilateral huge thyroid neoplasm / 中国医师进修杂志

Objective To explore the advantage of anterior cervical muscle group approach at sternal end transection in removal of bilateral huge thyroid neoplasm.Methods One hundred and seven patient underwent removal of bilateral huge thyroid neoplasm were selected.Fifty-two patients were given neck white line incision thyroid surgery (control group) and 55 patients were given anterior cervical muscle group approach at sternal end transection for thyroid surgery (observation group).The operative time,operation field exposure effect,amount of bleeding in operation,postoperative complications,and postoperative drainage volume were compared between two groups.Results The operative time [(88.53 ± 5.95) min],amount of bleeding [(18.58 ± 5.95) ml],and postoperative drainage volume [(47.58 ± 14.76) rnl] in observation group were less than those in control group [(113.98 ± 15.85) min,(39.27 ± 16.32) ml,(73.90 ± 14.40) ml] (P ＜ 0.05),the postoperative complication rate was lower than that in control group (P ＜ 0.05).Operation field exposure effect in observation group was better than that in control group (P ＜ 0.05).Conclusions Removal of bilateral huge thyroid neoplasm with the sternal end approach is feasible and simple.The operation field exposure is better than the neck white line incision,complications after operation is less.It is worthy of clinical application.

Mathematical Models of the Teenager’s Skeletal Age Evaluation Based on CT Scan and Imaging Reconstruction of Medial Clavicular Epiphysis / 法医学杂志

Objective To explore the correlation between CTvolume rendering (VR) statistics and living age and to build the mathematical models for skeletal age evaluation based on the grow th rules of medi-al clavicular epiphysis of teenagers in China. Methods The thin layer CTscan and VR3D imaging re-construction of both sides of sternal ends of clavicles were exam ined for 684 teenagers aged from 15 to 25 in East and South China. The parameters of sternal end of clavicle including the longest diameter of epiphysis, the longest diameter of metaphysis, their length radio, area of epiphysis, area of meta-physic, their area ratio, and other data were measured and calculated in order to establish mathematical models of skeletal age evaluation. Fifty trained subjects were tested to verify the accuracy of the math-ematical models. Results In the same age group, the length ratio and the area ratio had significant dif-ference in genders (P<0.05). The established mathematical models showed that the grow th rules of medial clavicular epiphysis were highly correlated with the living ages. The accuracies of these models were higher than 70.5% (±1.0 year) and 82.5% (±1.5 year). Conclusion The mathematical models have easy operability and high accuracy. It can be used to confirmand sustain the conclusion of atlas method. M eanw hile, it is of great significance to study the other single skeletal age evaluation in the future.