Applicability assessment and sociodemographic propertiesof gok, greulich-pyle and tanner-whitehouse atlases inthe bone age determination of married syrian refugeeswho are under the age of 18

Introduction and Aim: Age determination of refugees is one of the important subject in forensic medicine and law in the world and our country. Since 2011, there has been an increasing tendency in Syrian refugee migration to Turkey. This situation has led to intensive applications to our Forensic Medicine Department for age determination. Therefore, in this study, we aim to address the difficulties in the determination of age and to convey the reliability and the applicability of Gök, Greulich-Pyle and Tanner Whitehause atlases with the sociodemographic characteristics of the Syrian refugee cases under the age of 18 who applied to our department for age determination. Materials and Methods: In this study, the cases of Syrian refugees under the age of 18 who have applied to Gaziantep University Şahinbey Research and Training Hospital Forensic Medicine Department with court or prosecution office consent between the dates 01.01 2018 and 29.06.2019 for the purpose of bone age determination are examined. Left hand wrist radiographs and anamnesis of 178 female patients aged between 14 and 17 years have been evaluated retrospectively. Any kind of pathology such as metabolic, systemic disease and fractures or technically inappropriate shoots are excluded. The time between the birth dates and direct radiographs has been calculated as chronological age. Cases who completed 14 years and began 15th year have been accepted as the first group and then 2 more groups have been formed as Group 2 and Group 3 for each additional year. Bone age has been calculated according to Gök, Greulich-Pyle and Tanner-Whitehouse atlases after two forensic scientists have examined the direct wrist radiographs of these groups independently. The most widely accepted RUS (Radius, Ulna and Short bone) score has been used in the Tanner Whitehouse method. The sociodemographic data of all cases have also been examined. Findings:Inter-observer reliability is classified as strong and very strong by using Gök, GP and TW3 atlases and statistical analysis is carried out by averaging the results of the observations. The chronological ages are not found statistically significant for all three atlases for the 14-15 age group when compared with the bone ages according to atlases. Gök and Greulich-Pyle atlases for the 15-16 age group are staslically significant but poorly matched. For the 16-17 age group, Gök and Greulich-Pyle atlases are not found significant. Standard deviations in all three atlases according to age groups were less than 1 year. A strong correlation is observed among age atlases. The majority of Syrian refugees are unofficially married (religious marriage) and have children, and most of them have primary or lower level of education. Conclusion: Gök and Greulich-Pyle atlases are found to be applicable in Syrian refugee females between the ages of 15-16. It is concluded that for the 14-15 age group Gök, Greulich-Pyle and Tanner Whitehouse; for the 16-17 age group Gök and Greulich-Pyle atlases can be applied by taking one-year standard deviation into consideration.