Clinical Report: Combined Clavicle Model May Improve Age Estimates

Overview

A multivariable model combining skeletal maturation and clavicle length enhances forensic age estimation accuracy, particularly for identifying individuals aged 18 years or older. The study demonstrated that this combined approach outperforms traditional single-indicator methods.

Background

Accurate age estimation is critical in forensic medicine, especially for legal determinations regarding adulthood. Traditional methods often rely on single indicators, which may not provide sufficient accuracy. This study explores a combined model that integrates multiple factors to improve age estimation outcomes.

Data Highlights

Key Findings

• The combined model (MCE stage, clavicle length, and sex) showed superior performance with an area under the curve of 0.94.
• Overall accuracy of the combined model was 87%, with 91.4% sensitivity for identifying adults.
• Single-variable models did not achieve the same accuracy as the combined approach.
• Clavicle length was a significant predictor of age in patients aged 10 to 15 years but not in those aged 16 to 20 years.
• Conventional radiography may be limited by overlapping anatomical structures.
• Statistical modeling is recommended over rigid thresholds for evaluating imaging data.

Clinical Implications

The findings suggest that incorporating multiple indicators into age estimation models can significantly enhance accuracy, particularly in legal contexts. Clinicians and forensic specialists should consider using combined models for more reliable assessments of age.

Conclusion

Transitioning to a multivariable approach in forensic age estimation can reduce false negatives and improve the reliability of age assessments. This study supports the need for updated methodologies in forensic practice.

References

1. De Donno G., Journal of Forensic Sciences, 2023 -- Combined Clavicle Model May Improve Age Estimates
2. The Role of Clavicular Length as a Potential Risk Factor in Sternoclavicular Joint Osteoarthritis, 2025
3. Does 3D Printing Reduce the Need for Implant Removal Due to Discomfort in Midshaft Clavicle Fractures? A Four-Year Study, 2020
4. Innovative Radiographic Metrics for Assessing Vertical and Horizontal Instability in Acromioclavicular Joint Dislocations, 2017
5. Forensic age estimation of adolescents using computed tomography of the clavicles, International Journal of Legal Medicine, 2024
6. Estimation of forensic age using substages of ossification of the medial clavicle in living individuals, PubMed, 2015
7. Radiological age assessment based on clavicle ossification in CT: enhanced accuracy through deep learning, International Journal of Legal Medicine, 2024
8. Impact of Bone Tunnel Location on Shear Stress at the Coracoid Process Following Coracoclavicular Ligament Reconstruction: A Finite Element Analysis and Imaging Study
9. Forensic age estimation of adolescents using computed tomography of the clavicles | International Journal of Legal Medicine | Springer Nature Link
10. Estimation of forensic age using substages of ossification of the medial clavicle in living individuals - PubMed
11. Radiological age assessment based on clavicle ossification in CT: enhanced accuracy through deep learning | International Journal of Legal Medicine | Springer Nature Link