1. Topic :Pelvis and Medico legal importance
Presenter : Dr. Soreingam Ragui
Moderator : Prof. H. Nabachandra

2. INTRODUCTION
• The hip bone ossifies from 3 primary and
five sec centres.
• The primary centres appear at :
• 2nd month IUL : Ilium
• 4th month IUL : ischium
• 5th month IUL : pubis
• At birth the hip bone is ossified, except for
three cartilaginous part the iliac crest,the Y –
shaped cartilage and a strip along the
inferior margin of the bone including the
ischial tuberosity.

3. The pelvis is the region of the body
surrounded by the pelvic bones and the
inferior elements of the vertebral column.
• The bony pelvis if formed by four bone.
• right and left pelvic bones ( In front and lat)
• The sacrum and coccyx ( Behind )
• Four joints : two sacroiliac jnts, pubic
symphysis ,sacrococcygeal jnt.

6. MEDIAL VIEW

7. LATERAL VIEW

8. • Terms
• Pelvic inlet
• pelvic inlet is an oblique plane, making an angle of 50 to
60 deg with the horizontal.
• Post : Sacral promontory.
• Ant : upper margin of pubic symphysis.
• On each side : Linea terminalis.
• Pelvic outlet
• Ant : inferior pubic ligament
• Post : coccyx
• On each side : Ischiopubic Rami

9. • Pelvic inlet
• Ant post diameter : upper border of symphysis to sacral
promontory
• Transverse diameter : Widest part of the pelvic brim
• Oblique diameter : iliopubic imminence to opp sacrio
iliac joint.

13. • Pelvic index ( Turner ) = a-p or conjugate diam X 100
• max trans diam
• Three types :
• Platypellic = X to 89.9 ( trans oval )
• Mesatipellic = 90 to 94.9 ( Rounded )
• Dolichopellic = 95 to X ( long oval )
• Greulish and thomas :
• Four types
• 1) Dolichopellic = ap or conj dia more than max trans diam
• 2 ) mesatipellic = max tranv dia is equal or exceeds it by no more
• than 1 cm.
• 3) brachypellic = trans dia exceeds conj dia by 1.1 to 2.9
• 4) platypellic = trans dia exceeds conj by 3 cm

14. • MEDICOLEGAL IMPORTANCE OF PELVIS
• Identification
• 1) Sex determination.
• a) qualitative
• b) quantitative
• 2) Age determination.
• a) anti mortem : Study of ossification of bone.
• b) postmortem : Morphology of the symphyseal
surface

15. SEX DETERMINATION
1) Qualitative method
By the study of morphological differences

16. TRAIT MALE FEMALE
PELVIS AS A WHOLE massive,marked muscle site Less massive,smooth
SYMPHYSIS higher lower
SUBPUBIC ANGLE V shaped,sharpe angle U shaped,divergent obtuse
OBTURATOR FORAMEN Large, often ovoid Small ,traingular
ACETABULUM Large, tends to direct laterally Small, tend to direct
anterolaterrally
GREATER SCIATIC NOTCH Small,close and deep Larger,wider and swallower
ISCHIO PUPIC RAMI Slightly everted Strongly everted
SACRIO ILIAC ARTICULATION large Small , oblique
PREAURICULAR SULCUS Not frequent More frequent,better
developed
ILIUM High tend to be vertical Low,leterally divergent
SACRUM Longer,narower,with more Shorted and broader,with
evenly distributed tendency to marked curve at
curvature,often 5+segment S1-2 and S3-4,5 seg rule
PELVIC BRIM Hearth shaped Circular,elleptical
TRUE PELVIS Relatively smaller Oblique, swallow and spacious

17. SEX DETERMINATION
• Quantitative method
• By measuring certain parameters

18. • Quantitative approach :( INDEX )
• Sciatic notch index : width of notch X 100 M=4 to 5
• Depth of notch F=5 to 6
•
• Washburn ischiopubic index :pubic lngth X100,M=73-94
• ischial length F=91-115
• Coporobasal sacral index:brth of 1st sacrl vertebraX100
• brth of base of sacrum
• M: 46.2 F:54.3
•

22. AGE DETERMINATION ( POST MORTEM )
• By observing the change in the symphyseal surface of
the pubic symphysis.

23. • Age determination : the pubic symphysis is probably
the best single criterion in deternmining age in third to
fifth decade.
• four major contribution are available
• 1) Todd. (1923)
• 2) Brooks . (1955)
• 3) Mckern and Steward (1957)
• 4) Suchey and Brooks (1990)

25. phase Sym surfac Ossific nod Ventral mar Dorsal mar extrimities
I- (18 to 19 ) Rugged horz none none none No definition
grove,fur,ridge
II- (20 to 21 ) Grove filing May appear Ventral sur begins No definition
dorsaly n behnd on symp sur bevel begins
III- ( 22 to 24 ) Ridge n furrow Present Bevel more More difinit No definition
progr going almost const prononce dorsal plateau
IV- (25 to26 ) Rapidly going present Bevel greatly Complete Lower
increased dorsal plateau commencing
V- (27 to 30 ) Little change maybe Beginning of Completely Lower cleare
vent border defined Upper forming
VI- (30 to 35) Granular maybe Vent border Defined Increse define
appearnce retain complte upper ,lower
VII- (35 to 40) Texture maybe complete defined Carry on
finer,activity dim
VIII-(39 to 44) Smooth,no rim maybe No lipping No lipping Oval outline +
IX – (44 to 55) Rim present Maybe Iregular No lipping Carry
lipped
X – (50+) Erosion and BROKEN ----------------- --DOWN-------- -------
erratic ossifi

26. TODD METHOD:

28. SUCHEY/BROOKS METHOD (FEMALE):

30. SUCHEY/BROOKS METHOD (MALE):

31. Female Male
Phase mean S.D. 95% range mean S.D. 95% range
I 19.4 2.6 < 24 18.5 2.1 < 23
II 25.0 4.9 19-40 23.4 3.6 19-34
III 30.7 8.1 21-53 28.7 6.5 21-46
IV 38.2 10.9 26-70 35.2 9.4 23-57
V 48.1 14.6 25-83 45.6 10.4 27-66
VI 60.0 12.4 > 42 61.2 12.2 > 34

32. • Comparision:
• Todd found no race or sex differences
• Steward felt child bearing may be a factor in causing
certain symphyseal change and concluded that
assesement of age in female by this methods cannot
be as accurate as in males .

33. AGE DETERMINATION (ANTE MORTEM )
• by observing the appearance and fusion of the
ossification centres with the help of a plain x ray

35. Bone fusion Galstaun Fleckers Davies and
(bengalis) (Australian ) parsons
F M F M (Englander
s)
Crest of illium 17-19 19-20 15-16 18 23
Ischium and 8.5 8.5 7 9 28
pubis
Ischial 20 20 20
tuberosity

36. • Conclusion
• Pelvic bone is the most important bone for sex
determination and also age determination ( in 3rd and
4th decade).
• Therefore a meticulous study of the pelvic bone is
required in cases where the identity of the person is not
know or when the determination of age is required by
law enforcing agencies.

37. • BROOKS, S. (1955). "Skeletal Age at Death: The Reliability of Cranial and Pubic Age
Indicators", AJPA 13:567-597.
• BROOKS, S and J SUCHEY (1990). Skeletal age determination base on the Os Pubis: A
Comparison of the Acsádi-Nemeskéri and Suchey-Brooks Methods." Human Evolution,
5:227-227-238.
• TODD, T (1920). "Age Changes in the Pubic Bones, I: The White Male Pubis", AJPA 3:
285-334.
• Reddy ,KSN .”the essentian of forensic medicine and toxicology “ 23 edt , 71
• Pillay, VV “text book of forensic medicine and toxicology “ 16 edt , 55
• Mathiharan,K and amrit k “Modi’s medical jurisprudence and toxicology “ 23 edt , 289

38. THE END