Forensic Anthropology Population DataStature estimation from the femur and tibia in Black South African sub-adults
Introduction
South Africa is a country plagued by high crime rates [1]. Recent statistics show that approximately 10% of the total number of deaths were recorded as non-natural deaths. Of these non-natural deaths 43.6% affected individuals between 15 and 19 years of age [1]. These bodies are presented to forensic pathologists for post-mortem examination and if the remains are found in a skeletonized or fragmented state, the assistance of forensic anthropologists is sought [2]. Forensic anthropologists assist with the identification of unidentified skeletal remains by compiling an osteobiographic profile that consists mainly of age, ancestry, sex and stature estimates. Of these attributes, stature estimation can contribute to the positive identification or exclusion of an unknown individual and as such it is routinely assessed during the analysis of adult skeletal remains [3]; however, when dealing with sub-adult skeletal remains emphasis is placed on the assignment of age and stature estimation is rarely attempted [4], [5], [6], [7], [8]. This is due to the paucity of knowledge related to stature estimation from sub-adults skeletal remains, especially for adolescents [9] and appears to be associated with the difficulties of stature estimation in sub-adults [3] where one is faced with considerable variation in growth and development between individuals and populations, changes in body proportions associated with the growth spurt and the fact that bone growth is allometric [9], [10], [11] Additionally, the cartilaginous growth plates and bone epiphyses are rarely preserved [12] and the contribution thereof to bone length and overall stature is unknown and changes throughout growth [4].
Notwithstanding these challenges, a few stature estimation studies from foetal skeletal remains [13], [14], [15], [16] and prepubescent sub-adults have been reported [5], [13], [17], [18], [19]. Additionally, a few studies have attempted to estimate stature from the skeletal remains of adolescents and include work by Telkkä et al. [13], Feldesman [9] and Ruff [20].
The studies exploring stature estimation in adolescents are based on data collected from longitudinal growth studies, mostly conducted in the early twentieth century [9], [20] and utilize the diaphyseal lengths of the major long bones measured from radiographs [9], [13], [20]. Only the mathematical method, consisting of regression analyses and the femur:stature ratio, have been described for sub-adult stature estimation [9], [13], [20]. Telkkä et al. [13] described stature estimation in Finnish sub-adults and based on the correlations between diaphyseal long bone measurements and stature, generated stature estimation equations for individuals younger than one, individuals between one and nine years of age and for adolescents aged 10–15 years. Similarly Ruff [20] generated age-specific stature estimation equations for sub-adults aged 1–17 years, based on radiographic data collected from the Denver Longitudinal Growth Study [21], [22], [23]. The application of Ruff’s [20] equations is hampered by the need for age estimates to the nearest year, which is very difficult to attain when dealing with skeletal remains [16], [24]. The errors for the stature estimation equations calculated by Ruff [20] are comparable to that reported for adults while, standard error of estimates presented by Telkkä et al. [13] are higher than adult errors.
Work by Feldesman [9] explored stature estimation in sub-adults aged 8–18 years, by comparing the femur:stature ratios in sub-adults and adults [9]. The results indicated changes in the femur:stature ratio from sub-adults to adults, with statistically significant differences noted between sub-adults aged 8–11 years and adolescents between 12 and 18 years. Sex differences were also noted in the femur:stature ratio for adolescents (12–18 years) and the author suggested the use of a sex-specific ratio for this age group [9]. A number of studies have also assessed the correlation between various body segments and stature, in living adolescents, including measurements of the foot [26], [27], [28], fingers [11], forearm [29] and the head [19]; all reporting reasonable stature estimation accuracies.
A few studies have considered the accuracies of sub-adult stature estimation equations with contradictory findings. Cardoso [6] assessed the accuracy of the stature estimation methods described by Telkkä et al. [13] and Feldesman [9] on sub-adult (1–14 years) skeletons, with known demographic information, from Portugal. Results indicated that both methods underestimated stature. These inaccuracies were associated with the stunted growth and proportionally shorter limbs observed in the Portuguese sample related to the low socio-economic background of these individuals [6]. The accuracy of the stature estimation regressions reported by Ruff [20] was assessed by Sciulli and Blatt [25] as well as Sutphin and Ross [7]. Sciulli and Blatt [25] tested the accuracy of the age-specific tibia and radius stature estimation equations on sub-adults with known demographic information, brought to the Franklin County (Ohio) Coroner. Results indicated relatively accurate stature estimates from both the maximum and diaphyseal lengths of the tibia and radius. Sutphin and Ross [7] assessed the accuracy of the stature estimation equations on sub-adult skeletal remains from Chile’s General Cemetery. Based on significant bone length and stature differences observed between Chilean and American sub-adults the authors suggested the use of these equations in prepubescent teens, but cautioned against the use in older sub-adult Chileans. These results support the cautionary note by Telkkä et al. [13] Smith [5], Cardoso [6] and Baines et al. [12] who advised against the application of sub-adult stature estimation equations on populations other than the population from which the equations were derived, due to environmental, nutritional, growth and proportional differences observed between populations [5], [6], [12], [13].
The importance of stature estimation for the positive identification of sub-adult skeletal remains has been highlighted by Imrie and Wyburn [30], Warren et al. [31] and Snow and Luke [5] and support the need for more research. Imrie and Wyburn [30] described the age, sex and stature from sub-adult skeletal remains recovered from a hillside in Scotland. The skeletal estimates were compared to the ante-mortem records of a missing sub-adult male and even though considerable time had lapsed between the disappearance of the sub-adult and the time the ante-mortem data was recorded, adjustments to the estimates for this time lapse allowed for a presumptive identification. The importance of stature estimation in the identification of sub-adults from commingled remains was demonstrated by Warren et al. [31]. Using skeletal maturity and stature estimation, sub-adult males were distinguished from an older sub-adult female following an airplane disaster. Likewise, stature estimation played an important role in distinguishing sub-adult females of similar ages as was described by Snow and Luke [5]. Apart from the important contribution to the positive identification of unknown individuals, estimates of stature also provide valuable information regarding growth, socio-economic status, secular change, health and nutrition of sub-adults [7], [8], [32], [33], [34]. The need to estimate stature in sub-adults with disabilities or skeletal abnormalities is also important in clinical settings as seen in pediatric orthopedics and prosthetics [18], [24], [35].
Adult stature estimation equations cannot be used when dealing with sub-adult remains as it greatly overestimates stature, resulting in inaccurate and unreliable results [9], [20], [27], [29]. Therefore, due to the general lack of standards regarding the estimation of stature in sub-adults, the aim of this study was to assess the correlation between stature and lower limb bone lengths and to subsequently derive regression equations for the estimation of stature in Black South African sub-adults.
Section snippets
Participants
Ethical approval for this study was obtained from the Human Research Ethics Committee—Medical, University of the Witwatersrand, South Africa (Clearance Certificate Number—M110414) and allowed for the recruitment of living participants. Written informed assent, prior to participation was obtained from participants who were recruited from Afrika Tikkun, Diepsloot, Johannesburg, South Africa. The parents and/or legal guardians of each participant also provided informed consent. Afrika Tikkun is a
Results
The measurements were deemed highly repeatable as all Pc-values (Table 1) were greater than 0.90 [52]. These results indicate that the measurements are reproducible using the described methods.
The sample included sub-adults aged 10–17 years with an average age of 13.1 ± 2.1 years for males and 13.2 ± 2.12 years for females. The descriptive statistics of the sample and the measurements are summarised in Table 2. Living stature for sub-adult males ranged between 129.0 and 173.3 cm (150.4 ± 12.3 cm),
Discussion
Research on sub-adult remains is hampered by the lack of large, modern, sub-adult skeletal collections with known demographic information [3], [4], [13]. As such most studies involved in sub-adult stature estimation rely on data collected from growth related studies [5], [9], [20], [33] utilizing radiographic imaging [5], [9], [13], [17], [20], [33], [35]. Limitations of radiological studies involve image distortions that lead to measurement errors as well as the exposure of participants to
Conclusions
This study is limited in its conclusions due to the small sample size available for analysis. This is partly due to the increased scanning time and costs involved in acquiring MRI scanograms for analysis [58], [60]. The small sample also necessitated pooling age groups that have shown to produce lower stature estimation accuracies [5], [20], [28]. Notwithstanding these limitations, the current study suggests possible sex and population differences, thereby confirming the need for sex and
Acknowledgements
The authors would like to thank each of the participants for their voluntary participation. The authors are also grateful to Mr. X Sampies, Ms. M Tshambula and Mr. T Raphela from Afrika Tikkun (Diepsloot, Johannesburg) and Dr M Haagensen, Ms. E Bussy and Ms. C Sguazzin from the Department of Radiology, Wits-Donald Gordon Medical Centre (Johannesburg) for their invaluable assistance. A special note of thanks to Dr T Esan and Mr J Hemingway for their assistance with the statistical analyses. The
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