Medico-legal evaluation of the patients examined for bone age determination in Pamukkale University Faculty of Medicine, Department of Forensic Medicine between 2013 and 2022

All the characteristics used to recognize, identify and distinguish a person from other people are called "identity". The identification of a living or dead person and the identification of the characteristics that will enable them to be distinguished from other people is called "identification" (identification, identification). Today, identification of living persons is not only an individual or social problem, but has also become an international issue. Determining age is also very important in identification. Age is one of the physical characteristics that constitute the medical identity of an individual, such as gender, height, weight, hair, skin, eye color, fingerprints, bones and teeth. Genetics, nutrition, disease and environmental conditions affect the age of individuals. There may also be differences between individuals in age determination. Bone age has an important place in both medical and forensic applications. It is important in the diagnosis and treatment process in the medical field and in decision-making processes in the forensic field. In our study, 257 cases who applied to the outpatient clinic in Denizli between January 2013 and December 2022 were retrospectively analyzed. The relationships of these cases in terms of year of presentation, gender, age of identity at the time of presentation, age claimed by the person, nationality, official authority, pregnancy, chronic disease, height, weight, secondary sex characteristics, and number of teeth were analyzed. In our study, it was determined that there were more females (n:182) than males (n:75), the mean age at presentation was 22.04 ± 13.72 years, the cases were most frequently admitted in 2019 with 36 (14.01%) cases, and 113 (44%) cases were in the 15-18 age group. It was determined that 103 (40.08%) cases were born in the hospital environment and 101 (39.30%) cases were born at home. It was determined that 119 (46.30%) cases were sent by the Public Prosecutor's Office, 114 (44.36%) cases were sent by the Civil Court and 24 (9.34%) cases were sent by the Criminal Court. It was determined that the majority of the cases, 121 (47.1%), applied as victims of sexual abuse/sexual assault. It was determined that 225 (87,55%) cases were citizens of the Republic of Turkey, 23 (8,95%) cases were citizens of Syria, 6 (2,33%) cases were citizens of Afghanistan and 3 (1,17%) cases were citizens of Iran. It was determined that 131 (51%) cases claimed that their real age was older than their identity age, 111 (43.2%) cases had no claim and their identity age was correct, 12 (4.7%) cases claimed that their real age was younger than their identity age. When the bone ages were analyzed, it was found that 92 (35.8%) cases were between 15-18 years of age. In 150 (58.4%) cases, the bone age was older than the identity age, in 14 (5.4%) cases the bone age was younger than the identity age, and in 39 (15.2%) cases the identity age and bone age were the same. It was determined that female cases mostly applied as victims of sexual abuse/sexual assault, while male cases mostly applied for age correction procedures. It was found that the educational level of the cases who applied for bone age determination in both genders were mostly primary school graduates and secondary school graduates. In conclusion, incomplete official records of births and deaths in undeveloped and developing countries lead to many uncertainties. Accordingly, it is observed that age determination cases are included in forensic medicine practices in order to eliminate these uncertainties related to age that arise during forensic processes. Keeping birth and death records regularly and recording birth dates by using official records in hospital documents instead of recording birth dates according to the statements of individuals will play an important role in eliminating the uncertainty. In addition, encouraging the birth to take place in a health institution rather than at home during follow-ups during pregnancy will ensure that official records of the moment of birth are recorded in a healthier way. Thus, in court processes related to age determination, the official authorities will be able to access this information directly from reliable birth records in the hospital by contacting the health institution where the birth took place. In addition, if a system is established throughout the country in which population information, including age, is reliably recorded, there will be no uncertainty about age in many cases with known identity. Key words: İdentification, bone age, age determination, forensic medicine