DETERMINATION OF SEX OF FEMUR BY COMBINATION OF PARAMETERS

Transcription

1 Original Article DETERMINATION OF SEX OF FEMUR BY COMBINATION OF PARAMETERS Md. Laeeque, Vivek Nirmale, C.V.Diwan ABSTRACT In most of the Medico legal cases for establishing the identity of the diseased the material brought are either decomposed or disintegrated body parts, the only material relied then can be only bones. Determination of sex by 100 % accuracy is needed to confirm identity. A number of studies using Demarcating point methods are available, but most of the times their efficiency in sorting the sex is very less. If more than one parameter is used for a bone at least one of the parameters may work and can help in determination of sex. Present study is an attempt to use combination of parameters for determination of sex by using demarcating point method. 203 Human adult femora of known sex (133 males & 66 females) available in Bone Bank of Department of Anatomy Government Medical College Aurangabad were used for the present study. s of femur like Vertical diameter of head, Transverse diameter of head, Biepicondylar width and Mid shaft circumference were measured tabulated and analyzed statistically. Mean, SD, P value Demarkating point of all parameters were evaluated, Demarkating points were cross validated singly and in combination. It was observed that the above parameters were statistically significant and the percentage of femora sorted by combination of parameters was far more than when the parameters were individually used. Thus combination of parameters can be used to get better efficiency in sorting of sex from bones. Key Words- Sex Determination, Demarcating points, Medico legal cases, Femur, Establishing identity. INTRODUCTION Sex determination of the unknown skeletal material is one of the most vital questions required to be answered with 100% accuracy in medico legal cases as a part of establishing identity of the diseased from skeletal remains. Numbers of studies have been done which use morphological and morphometric parameters having variable efficiency. Kete 1 working on femora from different regions of India, found that the values showed a regional variation & also a downward gradient from North to South. He recommended that in giving a medicolegal opinion, the average of that particular region should be considered for comparison. The knowledge of various dimensions of the femoral head in both sexes will not only help the anatomists and forensic experts in sexing the femora but will also be of immense importance in prosthesis of femoral head which may be used by the orthopedic 2 surgeons in femoral head replacement surgery. Present study is an attempt to evaluate and establish femoral parameters (viz vertical and transverse diameter of femoral head, biepicondylar width and mid shaft circumference) in the Indian race particularly the population of Maharashtra. MATERIALS AND METHODS 203 Human adult femora of known sex available in the Bone Bank of Department of Anatomy Government Medical College Aurangabad were used for the present study. 137 were of males and 66 of females all the bones used were free from deformity or damage, dry and properly preserved. All the bones were well documented for sex; race & all belonged to the residents of population of Maharashtra, India. They were cleaned well without soft tissue or cartilage & were thoroughly dried. All the bones had completed femoral growth as evidenced by the complete fusion of the proximal & distal femoral epiphysis. International Journal of Basic Medical Science - March 2013, Vol : 3, Issue : 6 173

2 MATERIALS Osteometer Scale. Sliding Vernier caliper. Non elastic thread. Marker pencils. PARAMETERS 1. Vertical Diameter of Head: Vertical diameter of head of femur was measured by using vernier caliper and measuring the maximum diameter of head in the vertical plane, as shown in the photograph no Transverse Diameter of Head: Transverse diameter of head of femur was similarly measured by vernier caliper as the maximum diameter in the transverse plane, as shown in the photograph no Biepicondylar Width: Maximum transverse width of the lower end of femur in anatomical position was measured using osteometer as shown in the photograph no Mid Shaft Circumference: The mid shaft of femur was first marked by measuring the length of femur by placing in anatomical position in osteometer from the head to the lower end and then marking the midpoint of the length. At this marked point the circumference of the shaft was measured using a flexible measuring tailors tape by starting from one fixed point running along the circumference up to the starting point, as shown in the photograph no.3. All the parameters were measured in mms and tabulated, statistically analyzed using T test. The Mean, Standard deviation, were obtained using the routine statistical methods and Excel programme of the computer. Demarcating points were obtained by using formula mean 3SD for males and females i. e Mean 3 SD of male is demarcating point for female and Mean + 3 SD of female is demarcating point for male. Cross validation of the data using the demarcating points for all the parameters was done singly and in combination. Sr no 1 Md. Laeeque et al, Determination of Sex of OBSERVATION Vertical diameter of Head Mean 3 S.D. Mean S.D. P value (for DP) M F M F M F < Transverse diameter of Head < Biepicondylar width < Sr no Mid shaft circumference < TABLE NO 1: SHOWING MEAN, SD, P VALUE AND M 3SD. (SCALE IN MMS) OF FEMORA. 4 Mid shaft circumference >81 <63 57% TABLE NO 2: SHOWING DP % OF BONES SORTED (MALE/ FEMALE) BY INDIVIDUAL AND COMBINATION OF PARAMETERS. DP is Demarcating point (Scale in mms) TABLE NO 3: SHOWING SUCCESS RATE OF DIFFERENT WORKERS WITH DIFFERENTIAL FUNCTIONS M DP F % of femora sorted 1 Vertical diameter of Head >43 <37 50% 2 Transverse diameter of Head >44 <37 45% 3 Biepicondylar width >75 <55 46% DISCUSSION Combined success rate 80% Although individual parameters are not totally 100% result oriented when these results are combined by applying more than one parameters demarcating point to the samples at least one of the demarcating point crosses, and the bone is easily sorted. The results are comparable with a number of works on Discriminant functions which are complicated and much mathematically oriented. Sr. No Name of the Worker Success rate 1 DiBennardo R. (1982) 3 82% 2 Wu L. (1989) % 3 King C.A., Iscan M.Y.(1998) % 4 Gita Mall, et all (2000) % 5 Tranco et al (1997) % 6. Ýsmail Özer (2008) % 7. Present Study (2010) without D F 80% 174 International Journal of Basic Medical Science - March 2013, Vol : 3, Issue : 6

3 Md. Laeeque et al, Determination of Sex of Above table indicates that the combination of parameters used in the present study although simple gives the comparable efficiency, with other complicated multivariate formulae. Maximum Head Diameter Population and study Male Female Mean S.D. Mean S.D. Javdekar B. S.(1962) Kate B.R. (1964) Iscan & Miller (1984) 11 Amer. Blackes Iscan & Miller (1984) 11 Amer.Whites PHOTOGRAPH 1: MEASURING THE VERTICAL DIAMETER OF FEMORAL HEAD Dittrick J & Myers (1986) 12, California Iscan & Shihai (1995) 13, Chinese Trancho et al (1997) 7, Spanish Iscan &Steyn (1997) 14 South African Whites King C.A. et al 5 (1998),Thai Purkait & Chandra (2002) 15, Indian Pandya A.M. et al (2012) 16 Right Left Present Study (2012) Transverse Diameter PHOTOGRAPH 2: MEASURING THE TRANSVERSE DIAMETER OF FEMORAL HEAD Vertical Diameter TABLE 4: COMPARISON OF MEAN AND STANDARD DEVIATION OF THE FEMORAL HEAD DIAMETERS IN THE PRESENT STUDY AND PREVIOUS WORKERS (SCALE IN MMS) Samuel A Asala (2002) 17 Pandya A.M. (2012) 16 Present study (2012) Combined all s (Present study) Vertical diameter of Head 33% 50% Transverse diameter of Head 33% 45% Maximum Diamter of Head Biepicondylar width Mid shaft circumference % % % 80% PHOTOGRAPH 3: MEASURING THE MID SHAFT CIRCUMFERENCE OF FEMUR TABLE5: COMPARISON OF SORTING OF FEMORA BY UNIVARIATE ANALYSIS OF PRESENT STUDY AND PREVIOUS WORKERS. International Journal of Basic Medical Science - March 2013, Vol : 3, Issue : 6 175

4 Md. Laeeque et al, Determination of Sex of Forensic Science Applications," Journal of Forensic Sciences, JFSCA, Voi.27, No.2, April, 1982, pp Wu L. Sex Determination of Chinese Femur by Discriminant Function: J Forensic Sci. Sep 1989 ; 34(5): PHOTOGRAPH 4: MEASURING THE BIEPICONDYLAR WIDTH OF FEMUR From the above table it can be seen that when individual parameter singly used by demarcating point method, the efficiency is only 23-33%. Whereas, the efficiency of individual parameter in present study are, 1. Vertical diameter of Head--50%. 2. Transverse diameter of Head ---45%. 3. Biepicondylar width---46%. 4. Mid shaft circumference---57%. And the efficiency of combination of all parameters is 80% which is far better than the individual parameters used either by previous workers or as in the present study. CONCLUSION Success rate of sorting of femora by combined use of more than one parameters has got a good appreciable efficiency. Differential functions which are population specific and tedious formulae can be avoided if combined use of DP is judiciously used in sorting of bones (male/female in medicolegal cases). BIBLIOGRAPHY 1. Kete (1964). Journal of Anatomical Society of India (JASI) Dec Chauhan R., Paul S.,Dhaon BK. Anatomical parameters of North Indian hip joints-cadaveric Study. J Anat. Soc. India 2002; 51(1): DiBennardo R., Tailor J.V. (1982). Taylor, J. V. and DiBennardo, R., "Determination of Sex of White by Discriminant Function Analysis: 5. King CA, Iscan MY, Loth SR. Metric and comparative analysis of Sexual diamorphism in the Thai femur. J. Forensic Sci 1998; 43: Gita Mall, Matthias G., Kristina-D. Gehring and Michael Hubig.(2000): Determination of Sex From Femora :Forensic Science International vol 113,(1-3), Sep 2000, Pages Trancho GJ, Robledo B, Lopez-Bueis I Sanchez SA. Sexual determination of femur using discriminate function analysis of a Spanish population of known sex and age, Journal of Forensic Sciences 1997; 42: Ysmail Ozer (2008) Sex Determination Using the Femur in an Ancient Japanese Population. Coll. Antropol. 32 (2008) 1: Javdekar BS. A Study of the measurements of the head of the femur with special reference to sex - A Preliminary Report. Journal of Anatomical Society of India 1961; 10: Kate BR. A study of the regional variation of the Indian femur- The Diameter of the Head- Its Medicolegal and Surgical Application. Journal of Anatomical Society of India 1964; 13(1): Iscan MY, Miller SP. Determination of sex from femur In Blackes and whites. Collegium Anthropologium 1984; 8: Dittrick J, Suchey JM. Sex determination of prehistoric central California skeleton remains using discriminant analysis of the femur and humerus, American Journal of Physical Anthropology 1986; 70: International Journal of Basic Medical Science - March 2013, Vol : 3, Issue : 6

5 Md. Laeeque et al, Determination of Sex of Iscan MY, Shihai P. Sexual diamorphism in the Chinese Femur. Forensic Sci Int 1995; 74: Steyn M, Iscan MY. Sex determination from the femur and tibia in South African whites, Forensic Science International 1997; 90: Purkait R., Chandra H.(2004):A Study of Sexual Variation in Indian Femur: Forensic Sci Int Nov 10;146(1): Pandya A.M., et al A Study of Sexual Dimorphism of Femoral Head In Gujarat Region J Indian Acad Forensic Med. Jan- March 2012, Vol. 34, No. 1.Pg no no Samuel A Asala The efficiency of the demarking point of the femoral head as a sex determining parameter, Forensic Science International, Volume 127, Issues 1 2, 25 June 2002, Pages Md. Laeeque Assistant Professor Govt. Medical College Aurangabad. 3. C.V.Diwan. Professor & HOD Govt. Medical College Aurangabad. 2. Vivek Nirmale Assistant Professor, Govt. Dental College, Aurangabad International Journal of Basic Medical Science - March 2013, Vol : 3, Issue : 6 177