Download - forensic medicine

JIAFM, 2007 - 29(4); ISSN: 0971-0973
Discussion:
At the elbow joint: Fourth degree epiphyseal union
is seen in all the cases. At the wrist joint: First
degree union is found only in age group of 16 years.
Second degree union is found in age group of 16
and 17 years. The third degree is found in 16 – 17
years. Fourth degree is found in 16 – 22 years. At
the knee joint: First and second degree union is not
found in 16 years age group but the third degree
union is found in 16 years. Fourth degree union can
be seen in all age groups. At the pelvis joint: Zero
degree union can be seen in 16 – 17 years. First
degree can be seen in16 – 18 years group. Second
degree union is found in 16 – 19 years group. Third
degree union is seen from 16 years to 20 years age
group. Finally, fourth degree union is seen in 16 – 22
years age group. Thus, in pelvis as the age
increases, the degrees of union also increase.
Hepworth SM (1929)[2] from his study on Punjabi
girls found that the conjoint epiphysis fused with the
shaft of the humerus at 15 years. The proximal
epiphyses of both radius and ulna fused with their
shaft at 15 years in girls. In the present series,
epiphyses at the elbow joint showed complete fusion
in all the 104 cases by the age of 16 years.
However, since the younger subjects below 16 years
of age are not studied, it was not possible to find out
the exact age of commencement of the epiphyseal
union. Lall R and Nat BS (1934)[3] found that the
conjoint epiphysis fused with the shaft at 15-16
years whereas the medial epicondyle fused at about
17 years, which is almost similar with the present
series. Lall R and Townsend RS (1939)[4] also
found that 100% union at elbow joint occurred by 14-
15 years. Epiphyseal union below 16 years of age
could not be studied in the present series. Kothari
DR (1974)[5] found that the distal ends of both
radius and ulna fused completely with their shafts at
17-18 years in female, which is in agreement with
the findings in our study. Prasad RS et al (1979)[6]
and Sahni D (1995)[7] found that the epiphyseal
union at the wrist joint has completed by the age of
16 years. Their finding is earlier in comparison to the
finding in this present series.
Saksena JS and Vyas SK (1969)[8] stated that the
epiphyseal union around the knee joint is completed
by the age of 16-17 years in girls which is similar to
the findings in this series. Paterson RS (1979)[9]
found that lower end of femur and upper end of
fibula showed complete epiphyseal union at 16
years in girls similar to the finding in this study.
Harrison RJ (1972)[10] in Cunningham’s textbook of
Anatomy, documented that the distal ends of both
radius and ulna fused at about 20-22 years, which is
much later than the finding in this study. Regarding
the knee joint, all the cases showed complete union
(4th degree) of all the epiphyses at the age of 17
years. Out of 104 cases, 4th degree union is seen
in 89.5% of the cases by 16th year. Like in other
joints the commencement of the epiphyseal union
could not be studied. Standring S (2005)[11] stated
that the upper end of tibia fused with the shaft at
about 16 years in female. The upper end of fibula
fused at 17 years in female. The lower end of femur
fused with the shaft at 16 years in female. Similar
findings are seen in the present series. Dasgupta
SM et al (1974)12 found that lower end of femur and
upper end of tibia showed complete epiphyseal
union at 17-18 years in girls. The proximal epiphysis
of fibula showed fusion at 20-21 years in girls. In his
study the cases of recent epiphyseal union, where a
white transverse line was still seen in place of the
epiphyseal cartilage, was also taken as complete
union and the so-called epiphyseal scar was
disregarded. In the present study, the epiphyseal
union is somewhat earlier than his observation.
In the pelvis, the epiphyseal union for the iliac crest
and ischial tuberosity were studied. In the girls, 4th
degree epiphyseal union at the pelvis has completed
by the age of 21 years. The number of cases (in
percentage) showing 4th degree union at 16,17, 18,
19, 20, 21, and at 22 years are 5.263%, 12.5%,
25%, 61.54%, 78.56%, and 100% respectively.
Hollinshead WH (1969)[13] documented that the
iliac crest and the ischial tuberosity fused to the
main mass by the age of 20-21 years. This is in
support of the present series. Sankhyan S et al
(1993)[14] also found that the iliac crest fused with
the mass, ilium at the age of 21.5 years. This is
similar to our finding. Bennet KA (1993)[15] found
that epiphysis on iliac crest fused completely by the
age of 23 years, and the epiphysis on ischium at 24-
25 years. In the present series the age of complete
epiphyseal fusion is much earlier. The correlation
coefficient is 0.58 in girls respectively. Regression
equation is Y=15.93+0.89X with a standard error of
1.65. According to various workers, the time of union
of epiphyses varies with geographical distribution,
and differences in dietary and hormonal factors.
Regarding the North-Eastern region of India, the
genetic and epigenetic factors like dietary and
geographical distributions may play a role in the age
of epiphyseal union. Different workers used different
criteria for epiphyseal union and for generalization.
Dasgupta SM et al (1974)[12] used the group
showing 100% union at the earliest as the criteria for
generalization. Lall R and Nat BS (1934)[3] and Lall
R & Townsend RS (1939)[4] used 75-90% union as
the criteria for generalization. In the present series,
the age group showing 100% union at earliest was
taken as the criteria for generalization. Therefore,
the difference in selecting the criteria for
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