Sex Estimation and Reconstruction of Tibia Length From Selected Tibial Measurements: a Radiological Study in a Sample of Adult Egyptians
Year: 2026
Type: article
Study design: Observational Study
Abstract: Background: Sex estimation and long-bone length reconstruction are essential in forensic human identification, particularly when complete skeletal remains are unavailable. The tibia shows substantial sexual dimorphism and has a strong relationship with overall stature, supporting its use for sex estimation and skeletal reconstruction. Objectives: This study aimed to develop population-specific models for sex estimation and tibial length reconstruction using measurements obtained from anteroposterior tibial radiographs of Egyptian adults. Methods: This retrospective cross-sectional study was conducted on anteroposterior tibial radiographs of 215 Egyptian adults (114 females and 101 males) collected from a private radiology center in Alexandria, Egypt. Maximum tibia length, proximal tibia breadth, distal tibia breadth, and mid-tibia breadth were measured. Sexual dimorphism was assessed using Welch’s t-test. Correlation and regression analyses were performed to develop equations for maximum tibia length reconstruction. Logistic regression and receiver operating characteristic curve analyses were used to evaluate the performance of sex estimation models. Results: All measurements were significantly greater in males than females (p <0.001). Proximal tibia breadth showed the greatest sexual dimorphism (Hedge’s g = 2.28). Maximum tibia length correlated positively with proximal tibia breadth (r = 0.68), distal tibia breadth (r = 0.65), and mid-tibia breadth (r = 0.47) (all p <0.001). Proximal tibia breadth was the best individual predictor of tibia length (R² = 0.462; standard error of the estimate = 2.36 cm), while combining proximal and distal tibia breadths produced the highest reconstruction accuracy (R² = 0.474; standard error of the estimate = 2.34 cm). For sex estimation, proximal tibia breadth achieved 90.7% classification accuracy and an area under the curve of 0.948. The best multivariable model incorporated proximal tibia breadth, maximum tibia length, and mid-tibia breadth, yielding an area under the curve of 0.956, with 89.7% accuracy, 85.3% sensitivity, and 93.5% specificity. Conclusions: Tibial measurements from anteroposterior radiographs may provide useful supplementary tools for sex estimation and tibial length reconstruction in Egyptian adults. Proximal tibia breadth was the most informative individual predictor, while multivariable models offered high overall performance, supporting their forensic application in cases involving incomplete or fragmented tibial remains.
Language: English
Subfield: Archeology (arts and humanities)
Field: Arts and Humanities
Domain: Social Sciences
Open Access status: diamond
OpenAlex ID: W7222887813