85

Sktlttal Agt: Lattr Yrars

union, some in a very high degree."* What is "lapsed union?"

As the term implies it is incomplete union in the sense that a process
once begun has not gone on to completion. Why this is so is not
clear. The vault bones have a very specialized structure: they
have two layers, an inner (tabula interna), and an outer (tabula
externa), separated by a vascular spongy-bone space (the diploe).
The impetus to closure seems to be from inner table to outer, i.e.,
TABLE 20
LocATtoNs oF FtNAL STAGE oP CLosuRE IN VAULT

Sagittal
Parts comp/. cloud:

Agt

No.

17-18
19
20
21
22
23
2:>-25
2&-27
28-30
31-40
41-50

55
52
45
37
24
26
27
25
29
43
6

Total

369

5
7
11
8
8
3
15
4
22
26
16

Parb comp!. dostd;

3
2
2
8
11
34
8

4
7
4
10
4
7
7
4
9
11

1
2
6
5
4
11
16
1
16
26

2
7
2
8
4

13
16

Surous

lambdoid

3
15
8
6
13
33

5
16
16
17

(tN

3)

Dwana/
Parts comp/. closed:
2

3
2
5

3
7
12
22
17
33

11

8
3
7

From McKern and Stewart, '57, Table 10.

endocranial to ectocranial. Let us assume that the biological age is

achieved so that closure is naturally in order; it begins inwardly and
it spreads outwardly (inner to outer table). In many cases it will
go on to completion and the suture is "closed" to the point where,
on the outer bone, it is difficult to discern. Often, however, the
closure force or process seems to lose energy, to dissipate itself, to
halt short of completion. In these cases the closure has "lapsed";
the ectocranial suture is incompletely united. This, of itself, is
often a recognizable feature, for the bone on either side of the
outer suture is piled-up or, as Todd put it, "clawed" and turned in
like the margins of the eyelids in cases of trachoma.
The point to be made is that ectocranial suture closure is so
basically variable that it should not be the final arbiter of saying
As ('arly as 1910 Jon<"S observed that "the external closure of the sutures may,
however, be but very little evident when within the skull the obliteration of the sutur"5
is complete."

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sutures are "good" or "bad" age indicators.

made to ascertain endocranial closure.*

3. THE RELIABILITY OF SUTURES AS AGE CRITERIA

We have already noted that, historically, many writers have

taken a very cautious view of the accuracy of age determination
via suture closure, a view shared, in principle, by Todd and Lyons
themselves. What of more recent views?

Agt

MW

10-19
20-29
30-39
4Q-49
50-59
60-69
70-79
80-89
Total

5 .0
6.6
9. 3
6 .1
12 .0
9 .8
13.0
10 .0
9.0

FW

4.2
6.8
II . 7
7.0
16.0
9 .1

From Cobb, '52, Table 6.

Negro.)

(M

TW

MN

FN

TN

Total

5.0
5. 4
8 .0
8.8
12.0
8.4
14. 5
10. 0
9.0

3.4
4. 3
8. 5
11 . 5
9.4
15.0
26.0
25 .0
12. 9

2 .5
4 .2
9.7
5.5
10.0

2. 9
4.2
9. 1
8.5
9.7
15.0
21.0
25 . 0
II. 9

3.6
4.8
8.6
8.7
10.8
10.6
18.0
17 . 5
9.9

17.0

male, F = female, T

8.1

total, W = white, N -

Hrdli~ka ('39), on ectocranial suture closure, said on the basis

of this criterion alone " one could hardly be relied upon in age
determination to within a c.loser limit than 10 years on either side
of reality." In 1937, Cattaneo reported on 100 miscellaneous
Argentine skulls and ruled that suture closure was only " a suggestive indicator" of age. In 1953, Singer concluded that estimation
of "precise age at death of any individual, gauged only on the degree
of closure of the vault sutures is a hazardous and unreliable process."
In 1952 Cobb, using the Todd and Lyon schedules of suture closure,
stated that age-assessment " can probably approximate the true age
of an individual within plus or minus nine years" (p. 840). His
supporting data are presented in Table 21.
An interesting historic note is not amiss here. Dobson ('52)
studied the skull of John Thurtell, "The College Criminal,"
hanged at the age of 30 years on 1-9-1824. The remains went to
the Royal College of Surgeons (London). It was noted that the

I recommend either removal of the calvarium or a sagittal section of the skull in order
to view the cndocranial as~ct of the skull.

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Every effort should be

TABLE 21

Tht Human Skeleton in Fortnsic Medicine

AVER.AGE DEVIATIONS JN YEARS OP VARIATIONS OF STATED PROK SKELETAL AGE*

4
3
5
4

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Skeletal Age: LattT Years

88
vault sutures were "remarkably advanced for a subject of 30.
Without they are completely closed and obliteration (sic) is advanced at pars obelionica and pars bregmatica of the sagittal
suture." (In 1890 Dwight, and in 1905 Parsons, both said that
union may be complete by 30 years of age.)
The work of McKem and Stewart ('57) is of great value here.
They conclude that progress of suture closure "has only a very
general relationship with age. So erratic is the onset and progress
of closure that an adequate series will provide just about any pattern at any age level. Thus, as a guide for age determination,
such a trend is of little use. In other words, suture closure, as
either a direct or supportive evidence for skeletal age identification,
is generally unreliable." In last analysis, "if other ageing areas
of the skeleton are absent, then crude estimates can be made in
terms of decades only."* Genovese and Messmacher ('59a, '59b)
come to much the same conclusion, basing their findings on 101
male Mexican skulls of all ages and of known identity: for 47
"indigenas" and 54 "mestizos" the age difference between estimation via sutures, and actual age, was twelve years, eleven months
for the former, nine years, five months for the latter (eleven years,
one month over-all).
There is a residual problem to be mentioned, viz., that of the
absolutely premature closure of one or more sutures. Terminology
here is as follows: precocious closure is before age seven (the age at
which cranial growth is about 95% complete); premature closure is
after the age of seven, but considerably before the usual or "normal"
age of closure. The following tabulation (Bolk, '15) gives an idea
of observed frequency in a series of European white skulls of both
sexes.
The metopic suture, present at birth between right and left halves of
the frontal bone, usually closes at about two years of age. In a
certain number of skulls it is persistant well into adult life. Meto A very interesting example of the fallacy and/ or danger of relying upon a single agecritcrion (in the skull) is cited by Genovac ('60) and by Moa ('60). They cx.ami.ned
a prehistoric skull (about 8,000-10,000 ycan old) excavated at Tepcxpan, Mexico.
In a tint report M. T. Newman (pp. 97- 98 in DeTerra, Romero, and Stewart '49) had,
mainly on the basil of suture closure, assigned an age at time of death of 55-65 years.
When the akull was restudied on a comparative basis, and when radiographic studies
of the teeth were added, an age no greater than 25- 30 ycan could be assigned.

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The Human Skeleton in Forensic Medicine

ABSOLUTE FUQUENCY OP Pa.sWATUll OBLITERATION IN 1820 SKULLS

Timu

Sut. muto-occipitalia . . . . . . . . . . .
Sut. sagittalis . . . . . . . . . . . . . . . . . . . . . .
Sut. oquamooa .. . . . . . . .. . .

272
71
17

Sut. parict<HDaatoidca . . . . .

16

Sut. coronalia. . . . . . . . . . . . .
Sut. pariet~phenoidalis . . . .
Sut. fronto..phenoidalis . . . . . . . . . . . . . . . . .
Sut. lambdo1dea. . . . . . . . . . .

12
S
S
S

pism is more frequent among whites and Mongoloids (about 10%)

than among Negroids (about 2%) (Woo, '49; see also Montagu,
'38).
4. OTHER AGE CRITERIA IN THE SKULL

Both Todd ('39) and O:ibb ('52) note a series of changes which
are in part rather subjective. Certainly they have not been standardized either by definition or by statistical analysis. The texture
of a young adult skull is smooth and ivorine on both inner and
outer surfaces; at about 40 years ( 5) the surface begins to assume
a "matted," granular, rough-feeling, appearance. Certain markings appear with age: from age 25 years and on muscular markings
(lines of attachment) become increasingly evident, especially on
the side of the skull (temporal line), on the occiput (nuchal lines),
and on the lateral side of the jawbone (masseteric attachment);
on the inside of the skull, on either side of the sagittal suture, certain
pits or depressions (called Pacchionian depressions) become more
marked with age, both in depth and in frequency; also on the inside of the skull, laterally, the grooves for the middle meningeal artery become deeper. After about 50 years of age the diploe become
less vascularly channeled (venous sinuses) and there is an increasing
replacement by bone. There is no consistent age-change in the
thickness of the vault bones. Todd summarizes all this as follows :
"No obvious age changes are to be found in the markings of
venous sinuses or in Pacchionian depressions although deepening
of channels and sharpening of margins do occur in the grooves for
meningeal veins with advancing years. Changes due to age alone
in thickness of cranium and in diploe are not sufficient to emerge
on statistical analysis. The cause of obliteration of sutures in
childhood must be sought in phylogeny and is not an age character.
Granularity of surface of cranium, thickening or thinning of vault,

D lit z

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Skeletal Age: Later Years

The Human Sktltlon in Forensic M edicint

90
multiple vascular pitting of parietal bones and gross changes in
texture, often quite striking in the adult, are all features the cause
for which must be sought in chronic nutritional defect or other
constitutional infirmity. Halisteresis of cranial and facial bones,
like halistcresis in the skeleton, does set in after fifty years. This
however is indistinguishable from the osteoporosis consequent upon
constitutional defect and may indeed be a sign of supervening infirmity."

Summarizing Statement
1. The sutures of the cranial vault and of the circum-meatal
area are the best documented as far as age-changes are concerned.
In our present state of knowledge it may be stated that there are
no significant race, sex, or side (right/ left) differences.
2. Due to the phenomenon of " lapsed union" ectocranially,
the state of endocranial closure must take precedence in any evaluation of suture-age.
3. Estimation of age of the skull via suture closure is not reliable.
I'd venture to place a skull in a decade, for example in the 20's
or 30's or 40's, or at a decade mid-point, as 25-35, 35-45, and so on.
If the skull is the only part present then this sort of age evaluation
is the best one can do, and the statement is then diagnostic. If
other bones are present, then suture age may become, at best,
partially corroborative.
4. Other estimates of age in the skull, as texture, lineae, depressions, etc., are too subjective to be generally employed. A person with extensive experience may hazard an age approximation,
but that is all.
REFERENCES
BoLK, L.: On the premature obliteration of sutures in the human skull. AJA,
77:495- 523, 1915.
BROOKS, S. T.: I 955, (see Refs. Chap. IV).
CATTANEO, L.: Las suturas cranean en la dcterminacion de Ia edad. Examen de
100 craneos. Rev. dt la Assoc. Med. Argent., 50:387- 397, t 937.
COBB, W. M.: 1952, (see Refs., Chap. II).
DETERRA, H., ROMERO, J., and STEWART, T. D.: Tepexpan Man. Viking Fund
Puhl. in Anlkropol., No. 10, N.Y., 1949.

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DOBSON, J.: The College Criminal-John Thurtell. J. Deni. Assoc. S., Afr., 7(7):
265--268, 1952.
DwmHT, T.: The closure of the sutures as a sign of age. Boston Mtd. and Surg. J.,
122:389-392, 1890.
FREDERIC, J.: Untersuchungen fiber die normale,obliteration der Schiidelnllhte.
ZMA, 9:373-456, 1905.

FREDERIC, J.: Die Obliteration der Niihte des Gesicht-..chiidels. ZMA, 1.?:371440, 1909/ 10.
GENOVESE, S. T.: Revaluation of age, stature and sex of the Tepcxpan remains
Mexico. AJPA n.s., 18(3) :205--217, 1960.
GENOVESE, S. T . and MESSMACHER, M.: Valor de los patrones tradicionales para
la determinacion de la edad por mcdio de/ las suturas en craneos Mexicanos
(Indigenas y Mestizos). CU11dernos de lnstituto de Historia. Serie Antropol. No. 7,
Mexico City, t 959.
HRDLICKA, A.: t 939, (sec Refs., Chap. II).
JoNES, F. WooD: Anatomical variations, and the determination of the age and
sex of skeletons; pp. 221-262, in the Archaeological Survey of Nubia, Vol. IIReport on the Human Remains. Cairo: Natl. Printing Dept. , 1910.
LENHOSSEK, M . VON: Uber Nahtverknocherung im Kindesaltcr. Arch.j'rir Anlk.
N.F., 75:164-180, 1917.
McKERN, T. W. and STEWART, T. D.: 1957, (see Refs., Chap. II) .
MoNTAcu, M . F. A. : Ageing of the skull. AJPA, 23:355- 375, 1938.
Moss, M. L.: A reevaluation of the dental status and chronological age of the
Tepcxpan remains. AJPA n.s., 78(1) :71-72, 1960.
PARSONS, F . G . and Box, C. R.: The relation of the cranial sutures to age.
JRAI, 35:30-38, 1905.
PITTARD, E. and KAUFMANN, H.: A propos de I'obliteration des sutures cranicnnes et de leur ordre d' apparition. Recherches Sur les cranes de Boschimans,
Hottentots, et Griquas. L'Anth., ./6:351- 358, 1936.
ScHMIDT, E.: Anthropologi.sche Methoden: Anleitung zum Bcobachten und
Sammcln fur Laboritorium und Reise. Veit Co. , Leipzig, 1888.
S1NGER, R .: Estimation of age from cranial suture closure. J . Forrnsic Med.,
1(1) :52-59, 1953.
STEWART, T . D.: 1954, (see Refs., Chap. II) .
TooD, T. W.: 1939, (see Refs., Chap. II).
TODD, T. W. and LvoN, JR., D. W. : Endocranial suture closure, its progress and
age relationship Part I. Adult males of white stock. AJPA, 7(3) :325-384,
1924.
TODD, T. W. and LYON, JR., D. W.: Cranial suture closure, its progress and age
relationship. Part II. Ectocranial closure in adult males of white stock.
AJPA, 8(7):23-45, 1925a.
TooD, T. W. and LYON, JR. , D. W.: Cranial suture closure: its progress and age
relationship. Part III. Endocranial closure in adult males of Negro stock.
AJPA, 11(1):47- 71, 1925b.

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Skeletal Age: LAter Years

Toon, T. W. and LvoN, JR., D. W.: Cranial suture closure: its progress and age
relationahip. Part IV. Ectocranial closure in adult males of Negro stock.
AJPA, 8(2) : 149-168, 1925c.
Woo, Ju-KANG: Racial and sexual differences in the frontal curvature and its
relation to metopism. AJPA n.r., 7(2):215-26, 1949.

IV
Skeletal Age:
II

Later Years

The Pelvis

1. THE PUBIC SYMPHYSIS

The right and left hip-bones (ossa innominata) meet in the midline in front to form the pubic symphysis. The right and left pubic
bones do not actually articulate: they are separated throughout life
by the symphyseal cartilage. Each pubic bone presents a symphyseal surface or face, which Todd ('20) stated to be "a modified
diaphyso-epiphyseal plane and, as such, may be expected to show
a metamorphosis, if not actual growth, as an age feature."
In evaluating the role of the pubic symphysis as an age indicator
three major contributions are available: Todd (Studies I-VIII,
'2{}-'30); Brooks ('55); McKern and Stewart ('57). Todd's
is the early and significant contribution, so we shall discuss it
first. In principle he considered each pubic symphysis to possess
a more or Jess oval outline, with long axis supero-inferior ; this
oval had five main features: a surface; a ventral (outer) border
or "rampart"; a dorsal (inner) border or "rampart"; a superior
extremity; an inferior extremity; subsidiary features, found mainly
on the surface were: "ridging" and " billowing," and "ossific
nodules." These are all descriptive osteological features.
Varying and progressive combinations of these features resulted
in the establishment of 10 Phases of pubic symphysis age, ranging in
age from 18-19 years to SO+ years. These Phases were defined
by Todd (I, '20) as follows (see also Fig. 22 and Table 22):
I. First Post-adolescent: 18- 19 years. Symphysial surface
rugged, traversed by horizontal ridges separated by well
92

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Skeletal Age: Later Years

II.

II I.

IV.
V.

VI.

VII.

marked grooves; no ossific nodules fusing with the surface;

no definite delimiting margin; no definition of extremities
(p. 301).
Second Post-adolescent: 20-21 years. Symphysial still
rugged, traversed by horizontal ridges, the grooves between
which are, however, becoming filled near the dorsal limit
with a new formation of finely textured bone. This formation begins to obscure the hinder extremities of the horizontal
ridges. Ossific nodules fusing with the upper symphysial
face may occur; dorsal limiting margin begins to develop,
no delimitation of extremities; foreshadowing of ventral
bevel (pp. 302-303).
Third Post-adolescent: 22- 24 years. Symphysial face shows
progressive commencing formation of the dorsal plateau;
presence of fusing ossific nodules; dorsal margin gradually
becoming more defined; beveling as a result of ventral rarefaction becoming rapidly more pronounced; no delimitation of extremities (p. 304).
25-26 Years. Great increase of ventral beveled area; corresponding delimitation of lower extremity (p. 305).
27- 30 Years. Little or no change in symphysial face and
dorsal plateau except that sporadic and premature attempts
at the formation of a ventral rampart occur; lower extremity, like the dorsal margin, is increasing in clearness of definition; commencing formation of upper extremity with or
without the intervention of a bony (ossific) nodule (p.
306).
30-35 Years. More difficult to appraise correctly; essential
feature is completion of oval outline of symphysial face.
More individual variation than at younger ages; and terminal phases affect relatively minor details. Also, tendency
for terminal phase to be cut short. Increasing definition of
extremities; development and practical completion of
ventral rampart; retention of granular appearance of symphysial face and ventral aspect of pubis; absence of lipping
of symphysial margin (p. 308).
35-39 Years. Paramount feature: face and ventral aspect
change from granular texture to fine-grained or dense bone.
Changes in symphyseal face and ventral aspect of pubis
consequent upon diminishing activity; commencing bony
outgrowth into attachments of tendons and ligaments, espe-

94

The H uma11 Skeleton in Forensic M edicine

cia ll y the gracilis Lendon a nd sacra-tuberous ligament

(p. 310).
VJ! I. 39 ././ Years. S)'mphysial face generall y smooth and inactive; ,entral sur face of pubis also inactive; oval outline
complete or approx imately complete; extremities clea rly
d efined ; no d istinct " rim" 10 symphysial face; no mar ked
li pping of either dorsal or ventra l margin (p. 311).
I X. 45-50 Years. Characterized by well-marked " rim." Symphysia l face p resents a more or Jess marked rim ; dorsal
margin u niformly lipped ; ventra l margin irregularly lipped
(p. 312).
X . 50 Years +. R arefaction of face a nd irregular ossification.
Symphysia l face eroded a nd showing erra tic ossification ;
ventral border more or less broken down ; disfigu remen t
increases with age (p. 313).

O f these Phases Todd rema rked tha t as a w hole they we re " a

m uch more reliab le age indica tor from 20 years to 40 than after

Fig. 22.

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Modal sta ndards of Todd 's 10 typical phases.

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Skeletal Age: Later Years

95

-~

~ .g
iJj c

'
.,,
0

.
~ g~
~ Q~

rn

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.:
~

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cu

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96

The Human Skeleton in Forensic Medicine

the latter age (p. 313). Further (p. 63, '21, Summary of Parts
II-IV) he suggested that the Phases may be grouped into three
periods: 1-111, the post-adolescent stages; IV-VI, the various
processes by which the symphysial outline is built up ; VIl- X,
the period of gradual quiescence and secondary change. Todd
found no race or sex differences. Stewart ('57), however, feels
that child-bearing may be a factor in causing certain symphyseal
change (" pitting and irregularities in pubic symphyseal areas"
were noted in female Eskimo pelves) . He concluded that "assessment of age of females by the pubic symphysis cannot be as
accurate as in the case of males."
In his 1923 study Todd uttered words of caution to the effect
that " .. . unless it is absolutely unavoidable, the symphysis should
never be used alone . . .Age prediction is at best an approximation : the most sanguine would not expect the prediction to be
within Jess than two or three years if founded upon the entire
skeleton, or to within less than five years if founded upon the pelvis
alone" (p. 288).
In 1930, Todd (see also Burman et al., '34) set up four Phases in
the pubic symphysis discernible in the x-ray film, as follows (p.
283) :
1. 25 Years. Fine-texture body, undulating surface outline, no
definition of extremities, no streak of compacta.
2. 26-39 Years. Average-texture body, straight or faintl y irregular
surface outline, incompletely developed lower extremity, little
or n o grey streak of compacta.
3. 40-55 Years. Average-texture body, a straight or irregular
ventral outline, a well-developed lower extremity, and a fairly
dense grey streak of compacta.
4. 55+ Years. Open-texture body, an angular lower extremity,
and a dense grey streak of compacta broken into pa tches marking the ventral margin.
Thus a real undulating outline with no definition of extremities
and no grey streak of compact a, with a finely textured body, cannot
occur later than twenty-five years. A straight or faintly marked
irregular outline with an incompletely developed lower extremity,
little or no grey streak, and a fine or averaged textured bone, defines
Hanihara ('52) on 135 male Japanese skeletons found Todd's Phases workable,
though they tended to ovcragc some specimens.

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