IJAR.2024.119
Type of Article: Original Research
Volume 12; Issue 2 (June 2024)
Page No.: 8931-8939
DOI: https://dx.doi.org/10.16965/ijar.2024.119
Pattern of Major Sites of Ossification in Foetal Hand and Foot Bones: Implications for Estimating Foetal Maturity
Subhadra Devi Velichety 1, Ravindra Kumar B 2, Yogesh D 3, Meghana S. Poojari 4, Ashok Kumar Jyothi *5.
1 Professor and Head, Department of Anatomy, Apollo Institute of Medical Sciences and Research, Chittoor, Andhra Pradesh, India. ORCiD: 0000-0002-3995-8449
2 Assistant Professor, Department of Anatomy, Parul Institute of Medical Sciences & Research, Parul University, Vadodara, Gujarat, India. ORCiD: 0000-0003-0569-1472
3 Associate Professor, Department of Anatomy, Shridevi Institute of Medical Sciences & Research Hospital, Sira Road, Tumakuru, Karnataka, India. ORCiD: 0009-0009-8650-7649
4 Department of Anatomy, Basaveshwara Medical College and Hospital, Chitradurga, Karnataka, India. ORCiD: 0000-0001-5654-5294
5 Assistant professor, Department of Anatomy, Government Medical College, Khammam, Telangana. India. ORCiD: 0000-0003-4453-9262
Corresponding author: Dr. Ashok Kumar Jyothi, Assistant Professor, Department of Anatomy, Government Medical College, Khammam, Telangana. India. E-Mail: jyothiashok.anatomist@gmail.com
ABSTRACT
Background: The estimation of the foetal age at death is challenging in many ways. Therefore, determining foetal maturity is frequently a more plausible solution to the dilemma of foetal viability. In an endeavor to create a maturity spectrum, this research aims at the pattern of major sites of ossification in the foetal hand and foot bones.
Materials and Methods: The onset of main ossification centers in hand and foot bones was examined in 48 foetuses between 8 weeks and 9 months gestational age. Larger foetuses of 6 to 9 months of gestation (31.0 to 45.0 CMS CH lengths) were analyzed by roentgenography and by clearing procedure. Smaller foetuses of 20 to 205 mm CR length were cleared in potassium hydroxide, stained with Alizarin Red‑S, and examined for the appearance of ossification centers in the bones of the hand and foot.
Results: In this investigation, the centers were first formed in the hand bones before the foot bones, on the right side before the left, and in females before males. Ossification spreads from the radial to the ulnar side of the hand and from the tibial to the fibular side of the foot.
Conclusion: Relying on both size‑related and maturity‑related information will only boost the chance of getting close to genuine age when attempting to determine the age of foetal remains. Consequently, it is advised to use as much information as possible rather than taking a simple strategy, such as depending just on body size.
Keywords: Alizarin Red‑S, clearing, defatting, dehydration, KOH, ossification.
REFERENCES
[1]. Maclaughlin-Black S, Gunstone A. Early fetal maturity assessed from patterns of ossification in the hand and foot. Int J Osteoarchaeol. 1995;5(1):51-9.
https://doi.org/10.1002/oa.1390050106
[2]. Sadler TW. Langman’s medical embryology. Lippincott Williams & Wilkins; 2022.
[3]. Standring S. Gray’s Anatomy The Anatomical Basis of Clinical Practice. 42nd Editi. 36th, editor. Amsterdam: Elsevier; 2020.
[4]. Hita-Contreras F, Martinez-Amat A, Ortiz R, Caba O, Álvarez P, Prados JC, et al. Development and morphogenesis of human wrist joint during embryonic and early fetal period. J Anat. 2012;220(6):580-90.
https://doi.org/10.1111/j.1469-7580.2012.01496.x
PMid:22428933 PMCid:PMC3390511
[5]. Karmakar RN. Forensic medicine and toxicology. Academic Publishers; 2007.
[6]. Mughal AM, Hassan N, Ahmed A. Bone age assessment methods: a critical review. Pakistan J Med Sci. 2014;30(1):211.
https://doi.org/10.12669/pjms.301.4295
PMid:24639863 PMCid:PMC3955574
[7]. De Luca S, Mangiulli T, Merelli V, Conforti F, Palacio LAV, Agostini S, et al. A new formula for assessing skeletal age in growing infants and children by measuring carpals and epiphyses of radio and ulna. J Forensic Leg Med. 2016;39:109-16.
https://doi.org/10.1016/j.jflm.2016.01.030
PMid:26874435
[8]. Grant JCB. Method of Anatomy: A Clinical Problem-Solving Approach. Williams and Wilkins; 1989.
[9]. Gilsanz V, Ratib O. Hand bone age: a digital atlas of skeletal maturity. Vol. 1. Springer; 2005.
[10]. Anita, Kumar, Anand, Chhabra, Prabhjot Kaur. Study of Carpal Bone Ossification by Using Radiological Method for Age Estimation of Infant and Paediatric Group in North Indian Population. International Archives of BioMedical and Clinical Research, 2018;4(2):38-40.(https://imsear.searo.who.int/items/cbc60a70-3a15-4d60-b5c6-2b1ec8324c33)
https://doi.org/ 10.21276/iabcr.2018.4.2.14.
[11]. Srivastav A, Saraswat PK, Agarwal SK, Gupta P. A study of wrist ossification for age estimation in pediatric group in central Rajasthan. J Indian Acad Forensic Med. 2004;26(4):132-5.
[12]. Sidramappa HS, Hemanth RMN, Kumar AG V, Raju K. Radiological study of hand and wrist in the age groups 1-10 years in persons of North Karnataka. Int J Mod Trends Sci Technol. 2014;11:320-4.
[13]. Memon N, Memon MU, Junejo MA, Memon J. Age determination by employing radiological technique in pediatric age groups. J Liaquat Univ Med Heal Sci. 2011;10(2):53-8.
[14]. Udoaka A, Blessing D, Madueke C. Determination of skeletal age in Nigerian children: applicalibility of the Greulich and Pyle Atlas. J Forensic Sci. 2016;1:13-6.
https://doi.org/10.20431/2456-0049.0101003
[15]. Al-Khater KM, Hegazi TM, Al-Thani HF, Al-Muhanna HT, Al-Hamad BW, Alhuraysi SM, et al. Time of appearance of ossification centers in carpal bones: A radiological retrospective study on Saudi children. Saudi Med J. 2020;41(9):938.
https://doi.org/10.15537/smj.2020.9.25348
PMid:32893275 PMCid:PMC7557557
[16]. Alsharif MHK, Ali AHA, Elsayed AEA, Elamin AY, Mohamed DEA. Radiological estimation of age from hand bone in Sudanese infants and toddlers. Open J Intern Med. 2014;2014.
[17]. Maggio AK. Age estimation using the hand-wrist: morphological assessment of skeletal development in Western Australia. University of Western Australia; 2014.
[18]. Drennan JC. The child’s foot and ankle. Lippincott Williams & Wilkins; 1992.
[19]. Kuhns LR, Finnstrom O. New standards of ossification of the newborn. Radiology. 1976;119(3):655-60.
https://doi.org/10.1148/119.3.655
PMid:935405
[20]. Castellana C, Kósa F. Morphology of the cervical vertebrae in the fetal-neonatal human skeleton. J Anat. 1999;194(1):147-52.
https://doi.org/10.1046/j.1469-7580.1999.19410147.x
PMid:10227677 PMCid:PMC1467903
[21]. Patil SS, Wasnik RN. A Two-year Prospective Study of the Estimation of Foetal Age from Centres of Ossification by Radiography and Autopsy. Medico-Legal Update. 2012;12(2).
[22]. Staples Re, Schnellvl. Refinements in rapid clearing technic in the koh-alizarin red s method for fetal bone. Stain Technol. 1964;39:61-3.
[23]. Hess JH. The diagnosis of the age of the fetus by the use of roentgenograms. Am J Dis Child. 1917;14(6):397-423.
https://doi.org/10.1001/archpedi.1917.01910120002001
[24]. Hubbard AM, Meyer JS, Davidson RS, Mahboubi S, Harty MP. Relationship between the ossification center and cartilaginous anlage in the normal hindfoot in children: study with MR imaging. AJR Am J Roentgenol. 1993;161(4):849-53.
https://doi.org/10.2214/ajr.161.4.8372773
PMid:8372773
[25]. Larsen WJ. Essentials of human embryology. Churchill livingstone; 1998.
[26]. Ogata S, Uhthoff HK. The early development and ossification of the human clavicle-an embryologic study. Acta Orthop Scand. 1990;61(4):330-4.
https://doi.org/10.3109/17453679008993529
PMid:2402985
[27]. Mall FP. On ossification centers in human embryos less than one hundred days old. Am J Anat. 1906;5(4):433-58.
https://doi.org/10.1002/aja.1000050403
[28]. Bade P. Die Entwicklung des menschlichen Skelets bis zur Geburt. Arch für mikroskopische Anat. 1899;55(1):245-90.
https://doi.org/10.1007/BF02977733
[29]. Hill AH. Fetal age assessment by centers of ossification. Am J Phys Anthropol. 1939;24(3):251-72.
https://doi.org/10.1002/ajpa.1330240315
[30]. Flecker H. Time of appearance and fusion of ossification centers as observed by roentgenographic methods. AJR. 1942;47:97-159.
[31]. Jit I. Observations on prenatal ossification with special reference to the bones of the hand and foot. J Anat Soc India. 1957;6:12-23.
[32]. Noback CR, Robertson GG, others. Sequence of appearance of ossification centers in the human skeleton during the first five prenatal months. Am J Anat. 1951;89:1-28.
https://doi.org/10.1002/aja.1000890102
PMid:14877766
