Retrospective X-ray Assessment of Wrist Joint Ossification Centers for Age Estimation in a Regional Trauma Center of North India

Background Age estimation through radiological assessment of skeletal maturation is an important component of forensic and medicolegal practices, particularly in cases involving unidentified individuals, criminal responsibility, employment disputes, and absence of authentic birth records. Ossification and epiphyseal fusion around the wrist joint are considered reliable indicators for estimating chronological age during adolescence and early adulthood. Regional and ethnic variations in skeletal maturation necessitate population-specific standards. This study aimed to retrospectively evaluate the pattern of ossification and epiphyseal fusion around the wrist joint in a Northern Indian population. Methodology This cross-sectional observational study was conducted in the Department of Forensic Medicine and Toxicology under Apex Trauma Centre, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India. A total of 174 radiographs of the wrist joint from participants aged 14-24 years were analyzed, including 114 (65.52%) males and 60 (34.48%) females. Participants with chronic illnesses, endocrine disorders, musculoskeletal abnormalities, malnutrition, or unreliable age records were excluded. Radiological assessment included evaluation of epiphyseal fusion at the distal radius and ulna and ossification status of carpal bones. Fusion was classified as non-fusion, partial fusion, or complete fusion. Results Females demonstrated earlier epiphyseal fusion compared to males. At the lower end of the radius and ulna, partial fusion was observed as early as 14-15 years in 10 (62.5%) of 16 females and in 3 (20%) of 15 males at 15-16 years. The earliest complete fusion occurred at 16-17 years in 3 (33.33%) of 9 females and at 17-18 years in 3 (50%) of 6 males. Complete fusion at both the distal end of the radius and ulna was established in all participants (male or female) above 18 years of age. Ossification center for each carpal bone appeared in all participants. Conclusions Radiological examination of ossification centers around the wrist joint is a reliable method for age estimation in adolescents and young adults. The findings provide valuable regional reference data for the population of Eastern Uttar Pradesh and may assist forensic experts in medicolegal age determination.