Sex Determination by the Machine Learning Algorithms Through Using Morphometric Measurements of the Carpal, Metacarpal, and Phalangeal Bones / Determinación del Sexo Mediante Algoritmos de Aprendizaje Automático Mediante el Uso de Mediciones Morfométricas de los Huesos del Carpo, el Metacarpo y las Falanges

SUMMARY: In the study, it was aimed to predict sex from hand measurements using machine learning algorithms (MLA). Measurements were made on MR images of 60 men and 60 women. Determined parameters; hand length (HL), palm length (PL), hand width (HW), wrist width (EBG), metacarpal I length (MIL), metacarpal I width (MIW), metacarpal II length (MIIL), metacarpal II width (MIIW), metacarpal III length (MIIL), metacarpal III width (MIIIW), metacarpal IV length (MIVL), metacarpal IV width (MIVW), metacarpal V length (MVL), metacarpal V width (MVW), phalanx I length (PILL), measured as phalanx II length (PIIL), phalanx III length (PIIL), phalanx IV length (PIVL), phalanx V length (PVL). In addition, the hand index (HI) was calculated. Logistic Regression (LR), Random Forest (RF), Linear Discriminant Analysis (LDA), K-nearest neighbour (KNN) and Naive Bayes (NB) were used as MLAs. In the study, the KNN algorithm's Accuracy, SEN, F1 and Specificity ratios were determined as 88 %. In this study using MLA, it is understood that the highest accuracy belongs to the KNN algorithm. Except for the hand's MIIW, MIIIW, MIVW, MVW, HI variables, other variables were statistically significant in terms of sex difference.

En el estudio, el objetivo era predecir el sexo a partir de mediciones manuales utilizando algoritmos de aprendizaje automático (MLA). Las mediciones se realizaron en imágenes de RM de 60 hombres y 60 mujeres. Parámetros determinados; longitud de la mano (HL), longitud de la palma (PL), ancho de la mano (HW), ancho de la muñeca (EBG), longitud del metacarpiano I (MIL), ancho del metacarpiano I (MIW), longitud del metacarpiano II (MIIL), ancho del metacarpiano II (MIIW), longitud del metacarpiano III (MIIL), ancho del metacarpiano III (MIIIW), longitud del metacarpiano IV (MIVL), ancho del metacarpiano IV (MIVW), longitud del metacarpiano V (MVL), ancho del metacarpiano V (MVW), longitud de la falange I (PILL), medido como longitud de la falange II (PIIL), longitud de la falange III (PIIL), longitud de la falange IV (PIVL), longitud de la falange V (PVL). Además, se calculó el índice de la mano (HI). Regresión logística (LR), Random Forest (RF), Análisis discriminante lineal (LDA), K-vecino más cercano (KNN) y Naive Bayes (NB) se utilizaron como MLA. En el estudio, las proporciones de precisión, SEN, F1 y especificidad del algoritmo KNN se determinaron en un 88 %. En este estudio que utiliza MLA, se entiende que la mayor precisión pertenece al algoritmo KNN. Excepto por las variables MIIW, MIIIW, MIVW, MVW, HI de la mano, otras variables fueron estadísticamente significativas en términos de diferencia de sexo.

Classification and regression tree analysis for predicting morphological hand types based on radiography data / Análisis de árbol de clasificación y regresión para predecir tipos morfológicos de la mano basados en datos radiográficos

SUMMARY: Analysis and systematization of the longitudinal dimensions of the phalanges of the index and ring fingers for the classification of morphological types of the hand using classification and regression trees (CART). X-rays of the hands of 50 men and 50 women (mean age 47.16 (10.1) years, range 23-65 years) were studied. Each hand, depending on the ratio of the length of the index and ring fingers, was classified into three types: radial (R, 2d>4d), indefinite (N, 2d=4d), ulnar (U, 2d>4d). Morphometry of radiographs included measurements of the lengths of the proximal (PP), middle (MP), and distal (DP) phalanges. The sex differences of the analyzed indicators are statistically significant. There were no significant bilateral differences between the phalanges of the II and IV fingers in length, regardless of sex (p>0.05). A set of rules for classifying the morphological types of the hand depending on the lengths of the phalanges of the index and ring fingers was created by constructing a binary decision tree. The CART method demonstrates the usefulness of this statistical procedure for developing a scientifically based prediction of the morphological type of the hand. The results of this study can be the basis of an algorithm for determining the morphological type of the hand depending on the length of the phalanges of the fingers.

RESUMEN: En este estudio se realizó un análisis y sistematización de las dimensiones longitudinales de las falanges de los dedos índice y anular para la clasificación de tipos morfológicos de la mano, mediante árboles de clasificación y regresión (CART). Se estudiaron radiografías de las manos de 50 hombres y 50 mujeres (edad media 47,16 (10,1) años, rango 23-65 años). Cada mano, según la proporción de la longitud de los dedos índice y anular, se clasificó en tres tipos: radial (R, 2d> 4d), indefinida (N, 2d = 4d), ulnar (U, 2d> 4d). La morfometría de las radiografías incluyó mediciones de las longitudes de las falanges proximal (FP), media (FM) y distal (FD). Las diferencias de sexo de los indicadores analizados fueron estadísticamente significativas. No hubo diferencias bilaterales significativas entre las falanges de los dedos II y IV en longitud, independientemente del sexo (p> 0,05). Se creó un conjunto de reglas para clasificar los tipos morfológicos de la mano en función de las longitudes de las falanges de los dedos índice y anular mediante la construcción de un árbol de decisión binario. El método CART demuestra la utilidad de este procedimiento estadístico para desarrollar una predicción con base científica del tipo morfológico de la mano. Los resultados de este estudio pueden ser la base de un algoritmo para determinar el tipo morfológico de la mano en función de la longitud de las falanges de los dedos.

Asymmetric shape of distal phalanx of human finger improves precision grasping.

In morphology field, the functions of an asymmetric-shaped distal phalanx in human finger have only been inferred. In this study, we used an engineering approach to empirically examine the effects of the shape of distal phalanx on the ability of precision grasping. Hence, we developed artificial fingertips consisting of four parts, namely bones, nails, skin, and subcutaneous tissue, that substitute the actual human fingertips. Furthermore, we proposed a method to evaluate the grasping ability of artificial fingers. When a cylindrical object was grasped by an artificial fingertip, a pull-out experiment was conducted. Thus, the asymmetric type was found to be superior in terms of drawing force, holding time, and work of friction than the symmetric type. Our results clearly demonstrate that the asymmetric shape, particularly the mirror-reversed shape of the distal phalanx, improves the ability of precision grasping and suggests that the human distal phalanx is shaped favorably for object grasping.

Age estimation from the biometric information of hand bones: Development of new formulas.

INTRODUCTION: In the judicial context of the age estimation of living individuals, a new method was recently proposed, based on the collection of biometric information on hand bones radiographs. The aim of this study was to apply this method to a large French sample to provide new tools for age estimation MATERIALS AND METHODS: The study sample consisted of metacarpals and proximal phalanges measurements of 1003 individuals aged less than 21 years. This sample was divided into two subgroups 1-12 and 13-21 years as the age of 13 is a relevant legal threshold for most European countries. A quadratic discriminant analysis was performed to identify the group to which an individual was most likely to belong. Age estimation formulas were also constructed from linear models: for each subgroup and the total sample. RESULTS: The belonging of an individual to the 1-12 or 13-21 subgroup was determined with a correct classification rate of 89.8%. Age estimation formulas became less precise with age, with a mean absolute error ranging between 11 and 21 months. CONCLUSION: We proposed a two-step procedure for age estimation: firstly, the identification of the age group to which the individual is most likely to belong, and secondly, the age estimation of this individual by applying the appropriate formula.

Human manual distal phalanges from the Middle Stone Age deposits of Klasies River Main Site, Western Cape Province, South Africa.

Two new distal manual phalanges from the Middle Stone Age deposits of Klasies River Main Site are described. One (SAM-AP 6387) likely derives from ray II or ray III, whereas the other (SAM-AP 6388) is from the thumb. Both derive from a late adolescent or fully adult individual. They were recovered by H. Deacon from the same stratigraphic unit (submember W or possibly submember R) of the Shell and Sand Member of Cave 1, which places them between 100 and 90 ka. Both are comparatively small elements, and the possibility that they came from the same hand cannot be discounted at this time. These bones add to the meager and all too fragmentary postcranial human fossil sample from the Late Pleistocene of South Africa. These two specimens provide some additional evidence pertaining to the morphological attributes of the distal phalanges of the Middle Stone Age inhabitants of South Africa. Together with the distal pollical phalanx from Die Kelders (SAM-AP 6402), they are relatively small in comparison with homologs from recent human samples as well as Late Pleistocene specimens from Eurasia. Given their small sizes, the distal pollical phalanges from Klasies and Die Kelders are not dissimilar to Holocene Khoesan homologs. As expected, the Klasies elements differ noticeably from Neandertal homologs, especially in the narrowness of their shafts and distal tuberosities.

Extension Mechanism of the Proximal Interphalangeal Joint of the Human Phalanx: A Cadaveric Biomechanical Study.

Our purpose was to compare the contributions of these two systems to assess PIP joint extension in fresh cadaver models. Nine middle fingers of fresh cadavers were used. The PIP joint angle was measured while an extension load was applied on the extensor tendons. Specimens on which extension load was applied on the extrinsic extensors were classified as the extrinsic group, and those on which extension load was applied on the intrinsic extensors were classified as the intrinsic group. Linear regression analyses were performed to obtain regression equation and the extension load-PIP joint angle curve. The mean of slope of the curve was compared between the two groups using paired t-test. The same experiments were done for the metacarpophalangeal (MP) joint in 0° and 60° flexion to evaluate the effect of MP joint flexion on PIP joint extension. The mean slope of the extension load-PIP joint angle curve of the extrinsic group was significantly greater than that of the intrinsic group. With the MP joint in 0° flexion, the mean slope of the extrinsic and intrinsic groups was -0.148 and -0.117, respectively (greater absolute value means greater slope, p = 0.01). With the MP joint in 60° flexion, the mean slopes were -0.147 and -0.104, respectively (p = 0.015). The contribution of the intrinsic extensor for PIP joint extension shows decreasing trends with MP joint flexion. The extrinsic extensors have greater contribution for PIP joint extension compared with the intrinsic extensors.

Correlation between musculoskeletal structure of the hand and primate locomotion: Morphometric and mechanical analysis in prehension using the cross- and triple-ratios.

Biometric ratios of the relative length of the rays in the hand have been analyzed between primate species in the light of their hand function or phylogeny. However, how relative lengths among phalanges are mechanically linked to the grasping function of primates with different locomotor behaviors remains unclear. To clarify this, we calculated cross and triple-ratios, which are related to the torque distribution, and the torque generation mode at different joint angles using the lengths of the phalanges and metacarpal bones in 52 primates belonging to 25 species. The torque exerted on the finger joint and traction force of the flexor tendons necessary for a cylindrical grip and a suspensory hand posture were calculated using the moment arm of flexor tendons measured on magnetic resonance images, and were compared among Hylobates spp., Ateles sp., and Papio hamadryas. Finally, the torques calculated from the model were validated by a mechanical study detecting the force exerted on the phalanx by pulling the digital flexor muscles during suspension in these three species. Canonical discriminant analysis of cross and triple-ratios classified primates almost in accordance with their current classification based on locomotor behavior. The traction force was markedly reduced with flexion of the MCP joint parallel to the torque in brachiating primates; this was notably lower in the terrestrial quadrupedal primates than in the arboreal primates at mild flexion. Our mechanical study supported these features in the torque and traction force generation efficiencies. Our results suggest that suspensory or terrestrial quadrupedal primates have hand structures that can exert more torque at a suspensory posture, or palmigrade and digitigrade locomotion, respectively. Furthermore, our study suggests availability of the cross and triple-ratios as one of the indicators to estimate the hand function from the skeletal structure.

Phalangeal curvature in a chimpanzee raised like a human: Implications for inferring arboreality in fossil hominins.

Arboreal primates such as chimpanzees exhibit pronounced curvature in their hand and foot phalanges, which is assumed to develop throughout life in response to mechanical loads produced by grasping and hanging from branches. Intriguingly, ancient fossil hominins also exhibit substantial phalangeal curvature, which, too, has been interpreted as a direct result of habitual arboreality during life. Here, we describe the phalangeal curvature of a chimpanzee who was raised during the 1930s in New York City to live much like a human, including by having very few opportunities to engage in arboreal activities. We show that the degree of hand and foot phalangeal curvature in this individual is indistinguishable from that of wild chimpanzees and distinct from humans. Thus, rather than being a direct effect of mechanical loads produced by lifetime arboreal activities, phalangeal curvature appears to be shaped largely by genetic factors. An important implication of this finding is that phalangeal curvature among fossil hominins is evidently best interpreted as a primitive trait inherited from an arboreal ancestral species rather than proof of engagement in arboreal activities during life.

Evaluation and Treatment of Flexor Tendon and Pulley Injuries in Athletes.

Flexor tendon and pulley injuries in athletes present a unique challenge to the treating clinician. An understanding of the anatomy and mechanism of injury helps the clinician appropriately diagnose and treat the injury. Treatment may become more complicated when associated with delays in diagnosis, in-season considerations, and an athlete's desire to return to play. Two injuries involving the flexor tendon-pulley system, avulsion injuries of the flexor digitorum profundus tendon from its insertion onto the base of the distal phalanx and flexor pulley injuries, are examined in detail in this article.

Management of Metacarpal and Phalangeal Fractures in the Athlete.

Metacarpal and phalangeal fractures are common injuries in athletes and occur frequently in contact and ball-handling sports. They usually result after direct hits from other players or athletic equipment. The fractures often are minimally displaced and require a short period of immobilization followed by early range of motion for expeditious return to play. Unstable or intra-articular fractures may require operative fixation. Open reduction and internal fixation afford the most stability while allowing for early rehabilitation. Athletes represent a unique population, and treatment of these fractures requires consideration of specific sport, timing of injury, and level of play.

New evidence for an early settlement of the Yucatán Peninsula, Mexico: The Chan Hol 3 woman and her meaning for the Peopling of the Americas.

Human presence on the Yucatán Peninsula reaches back to the Late Pleistocene. Osteological evidence comes from submerged caves and sinkholes (cenotes) near Tulum in the Mexican state of Quintana Roo. Here we report on a new skeleton discovered by us in the Chan Hol underwater cave, dating to a minimum age of 9.9±0.1 ky BP based on 230Th/U-dating of flowstone overlying and encrusting human phalanges. This is the third Paleoindian human skeleton with mesocephalic cranial characteristics documented by us in the cave, of which a male individual named Chan Hol 2 described recently is one of the oldest human skeletons found on the American continent. The new discovery emphasizes the importance of the Chan Hol cave and other systems in the Tulum area for understanding the early peopling of the Americas. The new individual, here named Chan Hol 3, is a woman of about 30 years of age with three cranial traumas. There is also evidence for a possible trepanomal bacterial disease that caused severe alteration of the posterior parietal and occipital bones of the cranium. This is the first time that the presence of such disease is reported in a Paleoindian skeleton in the Americas. All ten early skeletons found so far in the submerged caves from the Yucatán Peninsula have mesocephalic cranial morphology, different to the dolicocephalic morphology for Paleoindians from Central Mexico with equivalent dates. This supports the presence of two morphologically different Paleoindian populations for Mexico, coexisting in different geographical areas during the Late Pleistocene-Early Holocene.

Karate Training Improves Skeletal Status Assessed by Quantitative Ultrasound in Girls and Premenopausal Women.

PURPOSE: The aim of the study was to assess the influence of regular karate training on the skeletal status evaluated by quantitative ultrasound (QUS) in females. METHODS: A group of 132 karate training girls and women at mean age 19.57 (standard deviation [SD] 7.64) yr (range 7.3-45.3 yr) and 322 age-, sex- and body size-matched controls were enrolled into the study. Mean training duration in the karate group was 7.52 (SD 5.05) yr and mean training frequency was 2.97 (SD 1.21) per wk. The QUS measurements were performed at hand proximal phalanges, using a DBM Sonic 1200 (IGEA, Carpi, Italy) sonographic device, which measures amplitude-dependent speed of sound (Ad-SoS [m/s]). RESULTS: The results of Ad-SoS obtained in karatekas were generally higher than in controls with significant difference for prepubertal girls (1966.2 [SD 46.2] vs 1942.7 [SD 38.4]; p < 0.05) and for adult women (2124.4 [SD 48.0] vs 2105.3 [SD 54.0]; p < 0.05). CONCLUSIONS: Regular karate training is a factor that is positively associated with results of the QUS measurements at hand phalanges in exercising females and its impact is most strongly pronounced in prepuberty and adulthood.

Insertion sites in manual proximal phalanges of African apes and modern humans.

OBJECTIVES: The primary aim of this study was to describe the insertion sites of the ligaments holding the flexor digitorum profundus and superficialis muscles (flexor ridges) in proximal phalanges 2-5 of African apes and modern humans. To interpret differences in flexor ridge size based on general behavioral differences among taxa. MATERIALS AND METHODS: We analyzed 3D models of manual proximal phalanges 2-5 from 29 gorillas (Gorilla beringei and Gorilla gorilla), 30 chimpanzees (Pan troglodytes) and 36 recent modern humans. Flexor ridges (mm2) were compared within and across genera. RESULTS: Gorillas and chimpanzees had larger flexor ridges for phalanges 2-4 than humans and this difference subsists when controlling for body size. Each genus had a unique insertion size pattern across the digits, with the most heterogeneous pattern found in chimpanzees, followed by humans, and lastly gorillas. These patterns corresponded strongly to the differences in the size of the phalanges within each genus, except for phalanx 5 in humans, which had a larger flexor ridge than expected. DISCUSSION: When comparing these genera, the flexor ridges signal differences between taxa that use their hands for manipulation and locomotion (gorillas and chimpanzees) and taxa that use them exclusively for manipulation (humans). This functional signal was also apparent in the PP5 of humans, whose larger FR may be indicating the high recruitment of this digit during forceful precision grip characteristic of humans.

Morphology of the Denisovan phalanx closer to modern humans than to Neanderthals.

A fully sequenced high-quality genome has revealed in 2010 the existence of a human population in Asia, the Denisovans, related to and contemporaneous with Neanderthals. Only five skeletal remains are known from Denisovans, mostly molars; the proximal fragment of a fifth finger phalanx used to generate the genome, however, was too incomplete to yield useful morphological information. Here, we demonstrate through ancient DNA analysis that a distal fragment of a fifth finger phalanx from the Denisova Cave is the larger, missing part of this phalanx. Our morphometric analysis shows that its dimensions and shape are within the variability of Homo sapiens and distinct from the Neanderthal fifth finger phalanges. Thus, unlike Denisovan molars, which display archaic characteristics not found in modern humans, the only morphologically informative Denisovan postcranial bone identified to date is suggested here to be plesiomorphic and shared between Denisovans and modern humans.

Bone Material Properties of Human Phalanges Using Vickers Indentation.

OBJECTIVE: To investigate the microhardness distribution throughout the human hand phalanges using the Vickers method, which can be used to directly evaluate the bone mechanical properties at tissue level and provide an alternative means to investigate bone quality. METHODS: The phalanges bones involved in this study were collected from three healthy donors; fresh-frozen right limbs were used. The phalanges bones were dissected and cut into 3-mm thick slices perpendicular to the long axis in the phalanges base, the phalanges shaft, and the phalanges head with a low-speed saw and then the slices were polished with sandpaper. A microindenter fitted with a Vickers indenter point was used to measure the Vickers hardness in the plantar, dorsal, medial, and lateral sites of cortical bone in metatarsal shaft and trabecular bone in the metatarsal base and head. The indentation load and dwell time was set to 50 g and 12 s for both the cortical and cancellous tissues in this study. For each site or region, five valid values were recorded and averaged as the Vickers hardness for the site or region. RESULTS: In total, 96 bone slices were harvested from the base, shaft, and head of the 15 phalanges and 1920 indentations were performed. In general, the Vickers hardness in phalanges was 34.11 ± 7.95 HV. For the 5 phalanges, the 3rd phalanx showed the highest hardness (36.74 ± 7.10 HV), closely followed by the 1st (36.46 ± 5.96 HV) and 2nd (35.28 ± 6.52 HV) phalanx. The hardness in the 4th (31.90 ± 9.15 HV) and 5th (31.19 ± 8.22 HV) phalanx were significantly lower than in the other 3 phalanges. The hardness in the phalanx shaft (38.52 ± 6.67 HV) was significantly higher than that in both the base (30.73 ± 7.46 HV) and head (30.64 ± 6.81 HV) of the phalanx (F = 300.7, P = 0.000); no statistic difference existed between the base and head of the phalanx (P = 0.996). The Vickers hardness in the proximal, middle, and distal phalanx showed statistical difference in Vickers hardness (F = 19.278, P = 0.000). The proximal phalanx showed higher Vickers hardness than the middle phalanx in the 2nd to 5th phalanges (P = 0.002). CONCLUSION: This study reported on the Vickers hardness distribution of the human phalanges bone and provides the theoretical basis of differences in hardness, which will benefit the placement of plates and screws in orthopaedic surgery and contribute to the research on ideal artificial bones and 3D-printed orthopaedic implants with inner gradient distribution of hardness.

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[The distribution of the main types of the papillary patterns on the distal phalanges of human fingers]. / Raspredelenie osnovnykh tipov papilliarnykh uzorov na distal'nykh falangakh pal'tsev ruk cheloveka.

The present study included the investigation of the four main types of the papillary patterns on the distal phalanges of all the ten fingers. As many as three million fingerprint cards have been used for the first time. The investigation yielded the exact quantitative characteristics of the frequency of occurrence of various papillary patterns. The importance of these findings for dactyloscopy and dermatoglyphics is discussed.

Evaluation of Articular Surface Similarity of Hemi-Hamate Grafts and Proximal Middle Phalanx Morphology: A 3D Geometric Morphometric Approach.

PURPOSE: Hemi-hamate arthroplasty has been described as a viable treatment option for unstable proximal interphalangeal joint fracture-dislocations. The procedure uses a dorsal distal hamate osteochondral graft to recreate the injured volar middle phalanx (MP) proximal base. The purpose of this study was to evaluate the similarity in shape of these articular surfaces using quantitative 3-dimensional methods. METHODS: Three-dimensional virtual renderings were created from laser scans of the articular surfaces of the dorsal distal hamate and the volar MP bases of the index, middle, ring, and little fingers from cadaveric hands of 25 individuals. Three-dimensional landmarks were obtained from the articular surfaces of each bone and subjected to established geometric morphometric analytical approaches to quantify shape. For each individual, bone shapes were evaluated for covariation using 2-block partial least-squares and principal component analyses. RESULTS: No statistically significant covariation was found between the dorsal distal hamate and volar MP bases of the middle, ring, or little digits. Whereas the volar MP bases demonstrated relative morphologic uniformity among the 4 digits both within and between individuals, the dorsal distal hamates exhibited notable variation in articular surface morphology. CONCLUSIONS: Despite the early to midterm clinical success of hemi-hamate arthroplasty, there is no statistically significant, uniform similarity in shape between the articular surfaces of the dorsal distal hamate and the volar MP base. In addition, there is wide variation in the articular morphology of the hamate among individuals. CLINICAL RELEVANCE: The lack of uniform similarity in shape between the dorsal distal hamate and the volar MP base may result in unpredictable outcomes in HHA. It is recommended that the variation in hamate morphology be considered while reconstructing the injured volar MP base in the procedure.

Custom 3D-printed finger proximal phalanx as salvage of limb function after aggressive recurrence of giant cell tumour.

Giant cell tumours (GCT) of the finger phalanges are extremely rare but have a high rate of recurrence. This report details the case of a GCT of the proximal phalanx of the fourth finger in a 64-year-old man. The patient was initially subjected to systemic neoadjuvant denosumab treatment, and subsequent aggressive curettage, sparing of the articular joints, local cryotherapy and autologous intercalary fibular bone graft. Finger function after surgery was considered satisfactory, despite limited proximal interphalangeal (PIP) joint motion. Aggressive local GCT recurrence was noted at the 32-month follow-up, with entire articular and diaphyseal phalangeal destruction. The patient refused amputation and, after analysing several reconstruction options, he was treated by entire en bloc resection and reconstruction employing a 3D-printed custom titanium implant. At the 24-month follow-up, the patient is free of disease and pain, and has a stable finger, good metacarpal-phalangeal joint motion, fusion of the PIP joint, a good Musculoskeletal Tumour Society score, and functional ability.