Forensic estimation of stature from sternal morphometry in the indian population: an autopsy-based anthropometric study

Background: Sex estimation is a fundamental step in the identification process during medico-legal investigations, particularly when dealing with fragmented or decomposed remains. The sternum, owing to its resilience and anatomical variability between sexes, serves as a valuable skeletal element for this purpose. Aim: This study aims to evaluate the reliability of various sternal measurements in determining sex in an Indian population. Methods: An observational cross-sectional study was conducted at the Department of Forensic Medicine and Toxicology, VMMC & Safdarjung Hospital, New Delhi, from January 2020 to June 2021. A total of 110 autopsied individuals aged between 10 and 70 years were included. Exclusion criteria comprised cases with fractured, deformed, or diseased sterna. After removal and maceration of the sternum, six osteometric parameters were recorded: length of manubrium, body of sternum, total sternum, and breadths of the manubrium and body, along with the sternal index. Receiver Operating Characteristic (ROC) curve analysis was used to evaluate the discriminative power of each parameter. Results: The study population comprised 84 males (76.36%) and 26 females (23.64%). All sternal parameters, except the sternal index (higher in females), were significantly greater in males (p < 0.0001). ROC analysis revealed that the length of the body of sternum was the most reliable predictor of sex, with an Area Under the Curve (AUC) of 0.906, sensitivity of 85.71%, specificity of 88.46%, and diagnostic accuracy of 86.36%. A cut-off value of >86 mm for males and ≤86 mm for females was established. The total sternal length and other parameters also showed acceptable to excellent diagnostic performance. Conclusion: Sternal measurements, particularly the length of the body of the sternum (86.36%), are reliable indicators for sex estimation in forensic settings. This study provides population-specific cut-off values for an Indian cohort, enhancing the utility of sternal morphometry in forensic anthropology and medico-legal practice.