European Journal of Cardiovascular Medicine

Determining or establishing the individuality of someone is the goal of personal identification. It may be absolute (complete) or partial (incomplete). The individuality of a person is fixed through complete identification. The identity of the person is determined by partial identification, while other information remains unascertained. Age, sex, race, and stature are the primary features of identification.

Stature is one of the most important data for identification, necessitated by medico-legal experts or medical jurisprudence as well as in anthropological research. There are studies that utilize whole limb lengths (both upper and lower) and finger lengths to estimate an individual's stature. However, there is a lack of important information regarding the estimation of stature based on percutaneous ulnar length in recent years, especially in this part of the nation.

Estimating an individual's stature is a fundamental practice in forensic anthropology and medico-legal investigations. The radius, a long bone of the forearm, is a reliable predictor of height due to its strong correlation with overall body size. This review examines key studies that have explored the use of percutaneous (surface) measurements of the radius for stature estimation, highlighting diverse methodologies, populations, and the development of population-specific regression formulas.

Early foundational studies in the mid-20th century, such as those by Trotter and Glesser (1) established the core principle that long bone lengths could be used to calculate stature. Their work primarily focused on skeletal remains, providing the basis for subsequent research on living individuals. Subsequent research, like that of Jit and Singh (2) on North Indian populations, demonstrated the necessity of developing population-specific formulas to account for regional and ethnic variations in body proportions.

An attempt was made by Issac Okai et. al. to derive equations for height and sex prediction, by measuring the ulna and radial lengths of 300 Ghanaian subjects, composed of 160 males and the rest of females, with a spreading caliper, measurement tape, and their heights with a help of the stadiometer. Regressions and discriminant function analysis were applied to the variables in SPSS to generate formulae for height and sex prediction respectively. The study showed that the mean height, ulna length, and radial length of the sampled individuals were 167.4, 28.6, and 25.9 cm respectively. Height showed a strong and significant positive correlation with the length of the ulna (r = 0.720, p < 0.0001) and radial length (r = 0.664, p < 0.0001). However, the data of the study showed that ulna length is a better predictor of height and sex than radial length. The accuracy of sex determination based on ulna or radial length alone was 82.3% and 75.3% respectively. (3)

Similarly, K.R. Nagesh (2011), estimated the stature from the length of the tibia, radius, and ulna in medical students belonging to the South Indian population. In his study, the multiple regression equations involving all three parameters showed higher correlation coefficients (0.829 in males and 0.747 in females). The regression equations were derived which help estimate stature from the lengths of the tibia, radius, and ulna in the South Indian population (4).

A study conducted in Rajkot by Pratik R. Varu et al., 2016 (5). Estimate the height using the percutaneous length of a radius in 200 random study samples. The structure was measured with the help of measuring tape and the percutaneous length of the radius was measured using a sliding caliper. Data was collected & analysis was statistically analyzed. It found that there was no significant difference between the right and left percutaneous length of the Radius (p>0.05). The mean stature & mean percutaneous length of the Radius were significantly higher for men than for females (p<0.05).

A significant body of work has focused on creating and validating these population-specific equations. Krishan and colleagues have published numerous studies on Indian populations, including a 2008 study that developed regression equations for both males and females from North India  (6). Similarly, Menezes (7) conducted research on a South Indian population, further underscoring that a single, universal formula is not accurate. This emphasis on population specificity is a recurring theme, with studies from diverse regions, including Ozaslan et al. (8) in Turkey, Ilayperuma et al. (9) in Sri Lanka, and Mahakkanukrauh et al.(10) in Thailand, all developing unique regression models.

The methodology for measuring the percutaneous radius length is another critical aspect of this research. The measurement is typically taken from the styloid process of the radius to the head of the radius, often using an anthropometer or spreading calipers. However, the accuracy of this measurement can be influenced by factors such as the amount of soft tissue, the skill of the measurer, and the precise identification of anatomical landmarks. Some researchers, such as Saini et al. (11) and Rastogi and Nath (12), have provided detailed methodologies for their anthropometric studies on different Indian populations.

Several studies have also investigated the correlation coefficient (r) and standard error of estimate (SEE) to assess the reliability of their models. The correlation between radius length and stature is consistently strong, often with an (r) value above 0.70. For example, a study by Gaur and Singh (13) on a population from Uttarakhand, India, reported high correlation coefficients for both sexes. The SEE is a crucial metric as it indicates the potential error range in the stature estimation, and most studies aim to minimize this value.

In recent years, research has also explored advanced techniques. Mahakkanukrauh et al.(10) utilized CT scans to obtain highly precise measurements of the forearm bones, demonstrating the potential for modern imaging to enhance accuracy, especially in cases of fragmented or disarticulated remains. Additionally, some studies have compared the accuracy of stature estimation from different long bones, finding that while the radius is a reliable predictor, using multiple bone measurements can further improve accuracy. The work of Mushtaq et al. (14) on a Pakistani population provides an excellent example of this comparative analysis.

After getting the permission from IEC of the Institute (Memo No.-BMC/IEC/100 dt. 22/06/2023), the informed valid consents were collected from willing participant Male and Female Students of 2^nd and 3^rd Phase of MBBS curriculum. Only the Male participants were included in the current cross-sectional observational study after being screened through following exclusion criteria:-

Exclusion Criteria-

1. Any apparent bone diseases.
2. Any apparent skeletal deformities.
3. History of fracture of long bones of forearms

Study sample - 122 male students were included as study popu;ation by complete enumeration method depending on the inclusion and exclusion criteria.

Techniques- The measurements  for the study were  taken as specified below: -

Measurements were taken by the same instruments (Stadiometer and Standardized Spreading calliper) by same observer, ignoring the soft tissue thickness. All these measurements had been repeated thrice and the mean value of the observation were noted to reduce the intra observer bias.

Stature (height) of the individual had been measured using Stadiometer in Frankfurt plane (with head adjust instrument) with subjects on standing and trunk straight position. The measurement were recorded in centimeters up to one decimal.

And after doing a 90-degree flexion at the elbow joint in the prone position of the forearm of the subject, the supracondylar ridge and lateral epicondyle of the humerus were palpated by the observer at the elbow joint. Then the subject had been asked to tap the fingers on the table which will enable the observer to feel the extensor digitorum muscle action over the lateral epicondyle. Just below the lateral epicondyle, the proximal end of the radial head which articulates with the capitulum of the humerus bone been  felt when supination-pronation movements are done in the forearm. The distal end of the radius has the styloid process posterolaterally. For confirmation of the distal end, the observer hold the distal end of the forearm and the subject were  asked to rotate the wrist joint. Then the landmarks were marked surface marking pencil.

Then the data had been tabulated and appropriate statistical tests [e.g. Mean, SD, SE, Correlation Coefficient etc] were done.

Total 199 students out of 400 of the 2^nd and 3^rd phase undergraduate MBBS Students, only 199 gave informed consent for being the study subject. The gender frequency distribution of the sample is shown in Table 1. Total sample size 199 among them 122 male and 77 female subjects. But only Male Samples have been included in the current study.

Table 1: - Frequency distribution of study subjects according to their gender (n=199)

Statistics

Table 2: - Frequency distribution of Male study subjects according to their Age. (n=122)

The age frequency distribution of the sample is shown in Table 2. Age Males varied between 18 years to 24 years

Table 3: - Descriptive Statistics- Mean, Standard deviation, minimum, and maximum of Male subjects according to their Age. (n=122)

The Descriptive statistics of all samples are shown in Table 3, The Mean and standard deviation of age of the male sample was 21.53 ± 1.306 years

Table 4: - Frequency distribution of Male study subjects according to their Age & Height. (n=122)

Table 5: - Descriptive Statistics- Mean, Standard deviation, minimum, and maximum of Male study subjects according to their height.

The height and age frequency distribution of all samples are shown in Table 5. Height and age of Males between 18 years to 24 years, 152cm to 188cm, The Mean and standard deviation of the height of the male sample were 171.37 ± 5.736 (cm).

Table 6: - Descriptive Statistics- Mean, Standard deviation, minimum, and maximum of all study subjects according to their Height & Percutaneous Length of Right Radius

The Descriptive statistics of Right Percutaneous Length of Radius (RPCLR) of all samples are shown in Table 8, The Mean and standard deviation of height of the male sample was 171.37 ± 5.736 (cm) The mean and standard deviation of Right Percutaneous Length of Radius of the males are 27.29 ± 1.340 (cm).

Table 7: Pearson's correlation coefficient of Height & Percutaneous Length of Right Radius of the Male study subjects.

The prediction of a significant relationship amongst the pair of variables was determined by the “Correlation coefficient” i.e., Pearson’s ‘r’. The relationship between the changes of a dependent variable (say, y) and an independent variable (say, x) was ascertained by simple linear regression, with the “Regression coefficient (m)”; where the model of the regression equation was y = mx + c [where c = y-intercept, when x = 0]. As in every equation; a 95% confidence interval (which was equivalent to 1.96 standard deviation) was accepted and the standard error of regression (STE) was calculated. The final equation model was y = (mx + c) ± (1.96 x STE).

The parameters were tabulated and statistically analyzed. The correlation coefficient (r) was found to be 0.912 (p=0.000) for the right ulna with stature, 0.915 (p=0.000) for the left ulna with stature, 0.904 (p=0.000) for the right radius with stature and it was 0.915 (p=0.000) for the left radius with stature.

Table 8: Regression Equations for Height with Percutaneous Length of Radius

• RPCLR: right Percutaneous Length of the Radius,
• Linear Regression Equation: the left radius (RPCLR), the equation Y = 3.30 * x + 81.17 indicates that each centimeter increase in the radius's length corresponds to an approximate increase of 3.30 cm in height, with a base height of 81.17 cm when the radius length is zero.
• Correlation Coefficient (r²): R² of 0.818 suggests that about 81.8% of the variation in height can be explained by the left radius length, indicating a strong positive correlation.
• P-value: A p-value less than 0.01 signifies that the relationship between radius length and height is statistically significant.

• the high r² values across these equations demonstrate a strong linear relationship between the lengths of the ulna and radius bones and an individual's height.
• the statistically significant p-values (<0.01) confirm that these relationships are unlikely to be due to random chance.
• these regression equations can be valuable tools in fields such as forensic science, anthropology, and medicine for estimating an individual's stature when only partial skeletal remains are available.
• It's important to note that while these equations provide useful estimates, they are based on specific study populations. Therefore, their applicability may vary across different populations due to factors like ethnicity, age, and sex. For instance, a study conducted in the Burdwan district of West Bengal derived similar regression equations for height estimation using ulna length in females, highlighting the importance of population-specific studies.^[17]
•  Regression analysis using the percutaneous lengths of the ulna and radius offers a reliable method for estimating height, with the strength and significance of the relationships underscored by the provided statistical metrics.

Graph 1: Right Percutaneous Length of Radius (RPCLR)

Scattered diagram showing the length of right radius to height taken in centimeters in the whole population.

Personal identification is a crucial aspect of forensic anthropology, especially in criminal investigations, mass disasters, and medico-legal cases. Stature estimation plays a significant role in forensic science, anthropology, and legal medicine, as it helps identify individuals when only body fragments are available. The estimation of stature from skeletal remains, particularly long bones, has been an area of extensive research. The present study aimed to determine stature from the percutaneous length of the radius and ulna in both sexes among 2nd and 3rd professional M.B.B.S. students at Burdwan Medical College.

The study analyzed the correlation between stature and percutaneous forearm bone lengths using statistical methods, including correlation coefficients and regression equations. The results demonstrated a strong positive correlation between stature and the percutaneous lengths of the radius and ulna, consistent with previous research conducted in different populations.

In the Current Study

The mean height of male subjects was 171.37 ± 5.726 cm.

The mean percutaneous length of the right radius was 27.29 ± 1.340 cm

The radius also showed a strong correlation with stature:

Right radius: r = 0.818, p < 0.0001

These findings indicate that both bones can be used reliably for stature estimation

Regression analysis was performed to derive equations for estimating stature from radial bone lengths

Right radius: Y= 3.30X + 81.17

The current study’s regression equations align closely with findings from other Indian population studies, suggesting that region-specific anthropometric models are valid but should be further refined with larger datasets.

This study concludes that the percutaneous lengths of the right radius can be effectively used to estimate stature. The findings reinforce the well-established relationship between long bone measurements and height estimation in forensic anthropology. The regression equations derived from this study can serve as a useful reference for forensic experts in cases where only forearm bones are available for identification.

A broader study with a more diverse population can further validate these findings.

FUNDING

This research received no specific grant from any funding agency in the public, commercial or not-for profit sectors.

ACKNOWLEDGMENT

We are sincerely thankful and grateful from core of our heart to the whole Department of FMT of Burdwan Medical College specially to Dr. Joydeep Khan and Dr. Surya.

CONFLICT OF INTEREST

 The authors declare that there is no conflict of interest. This research work is a part of the Dissertation of the First Author, submitted at the West Bengal University of Health Sciences in compliance with partial fulfilment of eligibility for the MD Examination for the year 2025.

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