Human identification from the ankle with pre- and postsurgical radiographs

Fifty-four sets of presurgical ("premortem") and postsurgical ("postmortem") foot and ankle radiographs were retrospectively evaluated to simulate a postmortem identification. The entire foot and ankle was examined in a previous study. The present study evaluates only the ankle for positive identification. Results are consistent with our earlier investigation of pre- and postsurgical foot and ankle radiographic comparisons and indicate that surgical intervention with subsequent healing does not preclude positive identification. However, the ankle contains fewer skeletal features unique to an individual than does the entire foot. Hence, the ankle may be less useful than the foot for establishing positive identification from radiographic comparisons.

Forensic implications of the foot and ankle

To clinicians, forensic medicine and the foot and ankle complex may appear to have little connection. However, if decomposed, burned, fragmented, or skeletonized human remains are recovered, the foot and ankle can provide information leading to identification and incident analysis. Furthermore, analysis of data collected at accidents can lead to safety modifications. This article reviews common elements of forensic medicine applied to the foot and ankle in 2 areas: establishing positive identification by using radiographic comparisons and analyzing aviation incidents. An understanding of these cases will enhance clinicians' awareness of the potential forensic value of the foot and ankle.