Kreitner K F, Schweden F J, Riepert T, Nafe B, Thelen M
Department of Radiology, Johannes Gutenberg University Mainz, Langenbeckstrasse 1, D-55131 Mainz, Germany.
Eur Radiol. 1998;8(7):1116-22. doi: 10.1007/s003300050518.
The development of the medial clavicular epiphysis and its fusion with the clavicular shaft have been a subject of medical research since the second decade of this century. Computed tomography provides the imaging modality of choice in analyzing the maturation process of the sternal end of the clavicle. In a retrospective study, we analyzed normal development in 380 individuals under the age of 30 years. The appearance of an epiphyseal ossification center occurred between ages 11 and 22 years. Partial union was found from age 16 until age 26 years. Complete union was first noted at age 22 years and in 100 % of the sample at age 27 years. Based on these data, age-related standardized age distributions and 95 % reference intervals were calculated. Compared to the experience recorded in the relevant literature, there are several landmarks that show no significant change between different ethnic groups and different periods of publication; these are the onset of ossification, the time span of partial union, and the appearance of complete union. Despite the relatively long time spans of the maturation stages, bone age estimation based on the study of the development of the medial clavicular epiphysis may be a useful tool in forensic age identification in living individuals, especially if the age of the subject is about the end of the second or the beginning of the third decade of life (e. g. in determining the applicability of adult or juvenile penal systems). Another possible use is in identifying human remains whose age is estimated at under 30 years.
自本世纪第二个十年以来，内侧锁骨骨骺的发育及其与锁骨骨干的融合一直是医学研究的课题。计算机断层扫描是分析锁骨胸骨端成熟过程的首选成像方式。在一项回顾性研究中，我们分析了380名30岁以下个体的正常发育情况。骨骺骨化中心在11至22岁之间出现。在16岁至26岁之间发现部分愈合。完全愈合最早在22岁时被注意到，在27岁时样本的100%完全愈合。基于这些数据，计算了与年龄相关的标准化年龄分布和95%参考区间。与相关文献中记录的经验相比，有几个标志在不同种族群体和不同发表时期之间没有显著变化；这些标志是骨化开始、部分愈合的时间跨度和完全愈合的出现。尽管成熟阶段的时间跨度相对较长，但基于内侧锁骨骨骺发育研究的骨龄估计可能是活体法医年龄鉴定中的一个有用工具，特别是当受试者的年龄约为第二个十年末或第三个十年初时（例如在确定成人或青少年刑罚制度的适用性时）。另一个可能的用途是识别年龄估计在30岁以下的人类遗骸。
