Sex determination from radiologic imaging of metacarpal and phalanx bones in a turkish population

Aim: Identification is one of the most crucial tasks in forensic sciences. In situations involving mass casualties, such as natural disasters, wars, and genocides, methods for identifying fragmented, highly decomposed, or skeletal remains become even more critical. Sex determination is a fundamental step in the identification process. This study aims to investigate whether metric measurements of metacarpal and phalangeal bones, obtained from direct radiographic images of the right hand, can be utilized for sex determination. Materials and Methods: Measurements of the metacarpal and phalangeal bones were performed on the radiological images of a total of 352 cases, consisting of 176 males and 176 females, who presented to Manisa Celal Bayar University Hafsa Sultan Hospital between January 1, 2013, and December 31, 2023, and underwent a right-hand radiography scan for various reasons. Logistic regression analysis was applied to the data obtained. Results: In our study, measurements and analyses revealed that the mean values for all length and width measurements of metacarpal and phalangeal bones were significantly higher in males compared to females (p<0.05). The bones providing the highest accuracy for sex determination were identified as the 2nd and 4th proximal phalanges, the 3rd middle phalanx, and the 1st and 4th metacarpals. According to Binary Logistic Regression Analyses, the accuracy rates for sex classification were as follows: for metacarpals, 89.2% in males and 87.5% in females; for all phalanges, 91.5% in males and 90.3% in females; for proximal phalanges, 89.2% in males and 86.4% in females; for middle phalanges, 84.1% in males and 85.8% in females; for distal phalanges, 84.7% in males and 82.4% in females. When considering all metacarpal and phalangeal bones collectively, the overall accuracy for sex classification was found to be 96.6% in males and 95.5% in females. Conclusion: The measurements performed on metacarpal and phalangeal bones demonstrated dimorphic characteristics and were found to be useful for sex determination. We consider that metric analyses based on metacarpals and phalanges could serve as a valuable alternative for sex determination, particularly in skeletal remains where pelvic and cranial bones are missing, fragmented or severely degraded. Anahtar kelimeler: Sex Determination, Metacarp, Phalanx, Forensic Medicine