Sex Estimation Using the Calcaneus – Wharton 1

Abstract
One of the most important aspects of the analysis and identification of human skeletal

remains is determination of the biological profile, which consists of the age, sex,

ancestry, and stature of an individual. Typically, anthropologists analyze the pubic

bone in adult human skeletal remains, which is highly sexually dimorphic due to a

female’s capacity for childbirth. However, when these fragile bones are broken,

damaged, or altogether missing, it is necessary to look to other areas of the skeleton

for sex information. DiMichele and Spradley (2012) developed a method of sex

estimation using four measurements of the calcaneus. For this project, this method

was tested using the left calcanei of modern American skeletal remains from the Texas
State University Donated Skeletal Collection (TXSTDSC). This skeletal sample consists
of 264

individuals (151 males, 113 females) with an average age-at-death of 65.2

years, 91.3% of whom are classified as white. The sectioning points for individual

measurements were able to accurately estimate sex for 76.7–80.9% of this skeletal

sample. Univariate and multivariate equations provided classification rates ranging

from 77.4% to 89.6%. The results of this study further validate that the calcaneus is

sexually dimorphic and can be used to estimate sex in a modern American skeletal

sample.

Sex Estimation Using the Calcaneus – Wharton 2

Acknowledgements

Many thanks to everyone who helped make this project possible…

The Cal U University Honors Program, Mr. Aune, Dr. Fox, Ms. Kim Orslene;

committee members: Dr. John Nass, Dr. Arrigo-Nelson, Dr. Meloy; Dr. Wescott and Sophia

Mavroudas from the Forensic Anthropology Center at Texas State; Cearra, who probably did
something, and

The most thanks to my advisor Dr. Kuba for absolutely everything.

Sex Estimation Using the Calcaneus – Wharton 3

Table of Contents

ABSTRACT

2

ACKNOWLEDGEMENTS

3

TABLE OF CONTENTS

4

INTRODUCTION

5

BACKGROUND

6

METRIC METHODS OF POSTCRANIAL SEX ESTIMATION

6

SEX ESTIMATION WITH FOOT BONES

7

MATERIALS AND METHODS

11

SKELETAL SAMPLE

11

STATISTICAL ANALYSES

14

METHODS AND MEASUREMENTS

12

RESULTS

15

INTER- AND INTRAOBSERVER ERROR

15

SEX ESTIMATION

16

DISCUSSION

18

CONCLUSION

19

LITERATURE CITED

20

Sex Estimation Using the Calcaneus – Wharton 4

INTRODUCTION
An accurate estimation of sex is the foundation of the biological profile. It is

undeniably useful in archaeological studies and essential in identifying human

remains in a forensic context. Additionally, many of the methodologies for estimating

age, ancestry, and stature are also dependent upon an accurate estimation of sex. An

anthropologist will usually look at the skull and the pelvis (or os coxae) for sex

estimation. The morphological features of the pelvis are highly sexually dimorphic

due to a female’s capacity for childbirth. The skull does typically show some sexual

dimorphism, though it can vary between different populations. Nonetheless, i t is

commonly a source of sex information for anthropologists.

Several scenarios may preclude use of standard methods of sex estimation.

Fragmentary, damaged, commingled, or otherwise incomplete human skeletal remains

often pose a challenge to anthropologists. Without complete and well-preserved os

coxae, other methods of sex estimation must be used. It is quite common to be faced

with this issue when dealing with archaeological remains, and though the absence of

complete and observable os coxae is less common in forensic cases, the phenomenon
is still important for any biological anthropologist to consider.

DNA analysis of skeletal remains can provide accurate determinations of sex,

but may not always be a viable option. This method can be costly and time-

consuming. Further, destructive analyses may not be permitted when working with

archaeological remains, and DNA samples could be contaminated. Therefore, it is

necessary to study alternative methods of sex estimation.

Spradley and Jantz (2011) have disproven the once-common belief that the

cranium is second best in providing accurate estimations of sex, leading to a shift in
anthropological research focusing on metric sex estimation with the postcranial

Sex Estimation Using the Calcaneus – Wharton 5

skeleton. This project focuses on a technique used to estimate sex from adult human
skeletal remains using the calcaneus (heel bone; DiMichele & Spradley, 2012). This
method was tested on modern American skeletal remains from the Texas State

University Donated Skeletal Collection (TXSTDSC) to determine the efficacy of this

bone to estimate sex with a variety of statistical methods including use of sectioning

points, univariate, and multivariate equations.

BACKGROUND
Anthropologists analyze the skull or pelvis in adult human skeletal remains.

However, when these fragile bones are broken, damaged, or altogether missing, it is
necessary to look to other areas of the skeleton for sex information.

Metric Methods of Postcranial Sex Estimation

Though established biological anthropologist Bill Bass once stated that “the

skull is probably the second-best area of the skeleton to use for determining sex,”

(Bass, 2005, p. 81) Spradley and Jantz (2011) have disproven this idea with an in-

depth study focusing on many postcranial skeletal elements’ ability to estimate sex. In
this study, standard cranial, mandibular, and postcranial measurements (Moore-

Jansen, Ousley, & Jantz, 1994) from 704 skulls and 639 postcranial skeletons (reported

separately because not all individuals were represented by both a skull and

postcranial skeleton) recorded in the Forensic Data Bank were used to estimate sex

with univariate and multivariate methods. They found that many metrics including

the humerus, radius, clavicle, femur, ulna, and tibia outperformed sex estimation with

the skull.

Further, many other works have demonstrated high accuracy rates using

univariate or multivariate equations, sectioning points, or other metric methods to

Sex Estimation Using the Calcaneus – Wharton 6

estimate sex from vertebrae, long bones, and other elements of the postcranial

skeleton for use in the absence of the os coxae (Albanese, 2013; Bethard, & Seet, 2013;
Holland, 1991; King, Işcan, & Loth, 1998; Marino, 1995; Marlow, & Pastor, 2011;

Safont, Malgosa, & Subira, 2000; Šlaus, & Tomčič, 2005; Steyn, & Işcan, 1999; Tise,

Spradley, & Anderson, 2013; Wescott, 2000).

Sex Estimation with Foot Bones

Many researchers have explored the use of foot bones to estimate sex in

skeletal remains. Several studies show that other foot bones such as the navicular,
talus, and calcaneus are sexually dimorphic.

Salidas, Malgosa, Jordana, and Isidro (2016) tested the navicular bone (one of

the tarsals in the mid-foot) for its use to estimate sex in contemporary Spanish

individuals. They analyzed the naviculars of 231 individuals from several university

skeletal collections in Spain. Eight variables were measured, and it was reported that

all measurements showed significant sexual dimorphism. Binary logistic equations
were created to estimate sex with these measurements and it was found that

maximum width and maximum length of the talar facet; maximum width and

maximum length of the cuneiform surface provided the most accurate results. Overall

high classification rates were shown for all of the equations used to estimate sex,

indicating that the navicular can be used for sex estimation (Salidas, Malgosa, Jordana,

& Isidro, 2016).

A 2003 study by Bidmos and Dayal looked at sex estimation using the talus of

South African whites. They looked at 9 measurements of 120 individuals and created

univariate and stepwise discriminant functions to estimate sex. They found that talus

length gave the highest univariate classification rate (81.7%), and height of the head

of the talus performed very poorly with a classification rate of 57.5%. The

Sex Estimation Using the Calcaneus – Wharton 7

discriminant functions provided accuracy rates between 77.5% and 87.5% (Bidmos &

Dayal, 2003).

Barrett, Cavallari, and Sciulli (2001) studied the talus in prehistoric Native

American skeletal remains from a variety of archaeological sites in the Ohio Valley

region. The “correct” sex was estimated using the os coxae and then compared with

talar measurements. Length, width, and height of the talus were measured for 74

males and 68 females. Each of the measurements was found to be significantly

sexually dimorphic. Using discriminant function analysis with all three variables, the

authors found an overall classification rate of 84.5%. The authors also observed talus

“volume” by multiplying the length, width, and height variables. This volume

measurement was the least sexually dimorphic, but had similar discriminating

abilities. This indicates that while the differences of volume between males and

females are small, they are consistent. All three measurements and “ volume” were

sexually dimorphic and show promise for sex estimation using the talus (Barrett,

Cavallari, & Sciulli, 2001).

Lee et. al (2012) tested the talus in Koreans for its use in sex estimation. Data

was collected from a total of 140 individuals from skeletal collections at Yonsei

University and The Catholic University of Korea. They used nine measurements seen

in previous studies and found similar sexual dimorphism in the talus. Univariate,

multivariate, and stepwise discriminant function equations were created to estimate
sex. They achieved accuracy rates between 67.1% and 87.1%. In addition to their
own mathematical methods, they compared their data to equations from another

study and found that they were not as accurate, supporting the idea that this is a

population specific method (Lee, et al. 2012).

Sex Estimation Using the Calcaneus – Wharton 8

A 2014 study by Mahakkanukrauh et al. looked at the talus of Thai individuals

from the Chiang Mai University Skeletal Collection. Ten measurements of the talus

were taken for 252 individuals (126 males and 126 females). The authors developed

logistic regression equations using the talar measurements and were able to estimate

sex with accuracy rates between 84.5% and 88.2%. They also found that trochlear

breadth and trochlear length were the most sexually dimorphic of their measurements

(Mahakkanukrauh, et al., 2014).
Calcaneus

Steele (1976) was among the first researchers to use the talus and calcaneus

for sex estimation. He took 5 measurements for each left talus and calcaneus from 120
individuals from the Terry Anatomical Skeletal Collection at the Smithsonian. This

collection consists of white and black Americans who died during or before the 1930s.
Discriminant functions from the data resulted in sexing accuracy rates ranging from

79% to 89%. However, Steele questioned whether these discriminant functions would

be accurate for more modern Americans, or if temporal changes would affect the use

of these bones for sex estimation. It was also found that the discriminant functions
are accurate with other ancestral groups, though sectioning points needed to be

altered for better results.

Introna et. al (1996) recreated the study done by Steele, focusing just on the

calcaneus but adding three more measurements. They studied 80 Southern Italian

individuals from skeletal collections at the University of Bari. Their univariate and

multivariate discriminant function equations both provided high accuracy rates with

up to 85% correct classifications. Additionally, data from the Italian skeletal sample

were tested with the equations developed by Steele, but were less accurate for

Sex Estimation Using the Calcaneus – Wharton 9

estimating sex. This stresses the need for population specific information and using

equations developed from the population of the individual being sexed.

DiMichele and Spradley (2012) analyzed the calcanei in 320 modern American

individuals from the Bass Donated Skeletal Collection housed at the University of

Tennessee Knoxville. They looked at four measurements: MXL, LAL, LAW, and PCF

(defined below in Table 2.3). Sectioning points were developed by taking the

weighted average between males and females for each measurement. Additionally, a

discriminant function multivariate equation was created to estimate sex.

Approximately 16% of the skeletal sample used in this study was non-white, with the
remaining 84% of individuals classified as white. Tests for correlations between

measurements and ancestry did show some significant trends, but it was determined

that the calcaneus is not a good estimator of ancestry. The authors also argue that if

the calcaneus is being used for sex estimation, it’s likely one of the most complete

bones available for analysis. Thus, an estimation of ancestry may not be prioritized

(DiMichele & Spradley, 2012)

The sectioning points resulted in classification rates ranging from 80.08 % to

88.10%, and the discriminant function equation was found to correctly assess sex for

88.64% of females and 84.75% of males. It is pointed out that though Spradley and

Jantz (2011) found that there were no differences in estimating sex with the calcaneus
for American whites and blacks, there may be differences among other populations.
Many other studies have also found similar results demonstrating that the

calcaneus is useful for sex estimation (Murphy, 2002; Peckmann, Orr, Meek, & Manolis,

2015; Bidmos & Asala, 2004).

Sex Estimation Using the Calcaneus – Wharton 10

MATERIALS AND METHODS
Skeletal Sample
The Texas State Donated Skeletal Collection (TXSTDSC) is a documented

skeletal collection consisting of individuals who lived and died in the 21 st century.

Donated bodies are first used in studies of human decomposition, and the skeletal

remains are later curated into the skeletal collection. Most of the donations are

individuals from the state of Texas, but bodies are accepted from all over the United
States and around the world.

A total of 264 adult individuals (113 females, 151 males) from the TXSTDSC

were used for this study. These individuals range in age from 18 to 102 with a mean

age of 65 years.

Table 2.1 – Skeletal sample age and sex information

Age

18-34

35-49

50-64

65+

Total

Females

4

9

35

65

113

Males
Total

10
14

8

17

55
90

78

143

151
264

Of the 264 individuals studied, 241 were classified as white, 9 as black, 11 as

Hispanic, and 3 as “other” (Table 2.2). Because of the small amount of non-white

individuals represented in the sample, all individuals were pooled and ancestry was

not used as a factor in this study. Additionally, as DiMichele and Spradley (2012)

found that the calcaneus is not a good estimator of ancestry. If the calcaneus is being

used for sex estimation, it is likely because it is one of the most complete bones, and
an estimation of ancestry may not be prioritized. No further tests for associations

between race and sex were performed.

Sex Estimation Using the Calcaneus – Wharton 11

Table 2.2 – Skeletal sample race information

Race

Black

Hispanic

White

Other

Percent

3.41%

4.17%

91.29%

1.14%

Count

9

11

241

3

Methods and Measurements
Left calcanei were measured for the purpose of consistency, and the right

calcaneus was used for individuals whose left calcaneus was missing. Any calcanei

which were too damaged or appeared to have any pathological conditions were

excluded from this study. Further, if the left calcaneus was excluded due to pathology

or damage, the right side was not used as a replacement since the issue was typically

reflected on both left and right calcanei in the same individual.

Measurements for length and width were taken using Mitutoyo Absolute digital

sliding calipers and measured to the nearest .01mm. Circumference measurements

were taken using a retractable fabric tape measure and rounded to the nearest 0.1cm.

The project investigator was kept blind regarding age and sex until after

measurements were taken.

Measurements taken include maximum length (MXL; Buikstra & Ubelaker,

1994), load arm length (LAL; Steele, 1976), load arm width (LAW; Buikstra &

Ubelaker, 1994; Steele, 1976), and posterior circumference (PCF; DiMichele &

Spradley, 2012), as shown in Figure 2.1 and Table 2.3.

Sex Estimation Using the Calcaneus – Wharton 12

Figure 2.1 – Calcaneus measurements

Table 2.3 – Measurement definitions

Measurements

Adapted From

Definition

Maximum Length

Buikstra &

most anterior point on the superior margin of the articular facet for

(MXL)

Load Arm Length
(LAL)

Load Arm Width
(LAW)

Posterior

Circumference
(PCF)

Ubelaker, 1994

Steele, 1976
Buikstra &

Ubelaker, 1994;
Steele, 1976
DiMichele &

Spradley, 2012

Distance between the most projecting point on the tuberosity and the
the cuboid measured in the sagittal plane and projected onto the
underlying surface.

Defined as the projected line from the most posterior point of the

dorsal articular facet, to the most anterior/superior point of the
cuboidal facet

Distance between the most laterally projecting point on the dorsal
articular facet and the most medial point on the sustentaculum tali

Defined as the minimum circumference of the area between the

posterior point of the dorsal articular facet and most posterior point of

the calcaneus.

Posterior circumference (PCF) was the only measurement which had not been used

multiple times in prior studies. Therefore, DiMichele and Spradley (2012) provide
additional explanation for this metric:

Sex Estimation Using the Calcaneus – Wharton 13

“To properly take this measurement, lay measuring tape flat against the surface

of the bone. Pass the measuring tape around anteriorly to the inner and outer

tuberosity of the calcaneus. Avoid projecting heel spurs located on the inferior

surface of the calcaneus by laying the measuring tape beneath them. In certain

cases, calcaneal tuberosities have been seen to be located at a more anterior

position, in which case it may be appropriate to measure on the posterior side
of the tuberosity, avoiding the feature, in order to properly obtain the

minimum circumference.” (DiMichele & Spradley, 2012, p. 2)

Additionally, cadaver stature (CS), defined as the maximum length of a cadaver

from the base of the heel to the top of the head, was used in some analyses.
Statistical Analyses
Inter- and Intraobserver Error

A sample of 23 individuals were measured in two separate trials by the author

several days apart, and once by an experienced observer to test for inter- and

intraobserver error.
Sex Estimation

Data collected from the TXSTDSC were used to estimate sex with the sectioning points

determined by DiMichele and Spradley (2012). Additionally, sectioning points were

derived from this skeletal sample by taking the weighted average between males and

females for each measurement. If a measurement is below the sectioning point, the

individual is estimated to be a female; if the measurement is over the sectioning point,
the individual is estimated to be a male. Pearson’s correlation coefficients were

calculated in Statistical Analysis Software (SAS) v. 9.04 (SAS Institute Inc., Cary, NC,

Sex Estimation Using the Calcaneus – Wharton 14

USA) to observe the correlations between each measurement, sex, and cadaver
stature.

All four measurements were used to create univariate functions for estimating

sex and a multivariate equation was created using all four variables. The sex variable

was coded as males=1; females=0 to calculate the mathematical equations, and 0.5

was used as a sectioning point for estimating sex. If the result of the equations is more
than 0.5, they are estimated to be a male; if the result is less than 0.5, they are
estimated to be a female.

RESULTS
Inter- and Intraobserver Error
Tests for inter- and intraobserver error show that these measurements are

replicable (Table 3.1). Interobserver error (2.11%) was overall higher than

intraobserver error (0.86%) indicating that different individuals may take

measurements slightly differently. However, intraobserver error was very low,

making it very easy to replicate results with the same observer. In both scenarios,

load arm length (LAL) had the highest error rates, indicating that this measurement is

less reliable than the others. In different individuals, the most anterior/superior point

of the cuboidal facet (a surface of the bone which contains a measurement landmark)

can vary in its location, which may have led to the differences in measurements. A

better-defined metric may clarify the issue to provide for lower error rates in the

future.

Sex Estimation Using the Calcaneus – Wharton 15

Intraobserver
Interobserver

MXL

Table 3.1 – Error rates

0.36
2.23

LAL

LAW

3.65

1.32

1.51

1.06

PCF

Average

1.24

2.11

0.52

0.86

Sex Estimation
The means and standard deviation for each measurement for males and

females are shown in Table 3.2.
Var

MXL
LAL
LAW
PCF

N

148
148
146
150

Table 3.2 - Simple statistics

Males
Mean

87.55
54.87
44.85
113.8

SD

4.83
3.17
2.66
7.3

N

109
108
111
112

Females
Mean
80.21
49.68
40.42
102.0

SD

4.31
2.90
2.33
6.3

Sectioning points developed for the current study were found to be close to

those of the study done by DiMichele and Spradley (2012), who also looked at modern
American individuals. Both the sectioning points from this study and those created by

DiMichele and Spradley (2012) provided high accuracy rates for sex estimation (Table

3.3).

Table 3.3 – Sectioning points and accuracy rates
MXL

LAL

LAW

PCF

Pooled accuracy rates

78.2

79.3

80.5

80.2

Pooled accuracy rates

78.2

80.9

79.8

76.7

Sectioning points from present study
Sectioning points from DiMichele & Spradley
(2012)

83.9

83.8

52.3

51.6

42.6

42.0

10.8

11.0

Sex Estimation Using the Calcaneus – Wharton 16

The Pearson correlation coefficients showed statistically significant

correlations between sex and each measurement. Additionally, cadaver stature also

showed high correlations with each of the measurements, indicating that calcaneal

measurements may be more closely associated with stature than with sex.
Table 3.4 – Pearson correlation coefficients
Sex

MXL

Sex

1.00

LAL

LAW

MXL

LAL

1.00

0.84

0.62

LAW

PCF

CS

0.64

0.66

0.65

0.72

1.00

0.74

0.72

0.70

PCF
CS

0.74

1.00

0.68

0.74

1.00

0.77

0.71

0.67

1.00

Each of the univariate equations provided high classifications for sex

estimation, ranging from 77.43% to 80.86%. All four equations classified males

correctly more often than females, meaning females were misclassified more often.

This could be due to the sample size and the ratio of males to females ( approximately
4:3). With sectioning points set at 0.5, it is assumed that there is an equal likelihood
of an individual being a male or a female. However, this is not the case with the
skeletal sample used in this study.

The multivariate equation was also able to classify sex with high accuracy, and

with similar results for males and females.

Sex Estimation Using the Calcaneus – Wharton 17

Table 3.5 – Univariate and multivariate equations and accuracy rates
l

MXL

0.0523

LAL

LAW
PCF

Constant
Sectioning point
Males classified correctly
(%)
Females classified correctly
(%)
Total classified correctly
(%)

2

-0.0798

3

-0.0976

4

-0.0356

5

-0.0067
-0.0263
-0.0356

-0.0144

-3.8405
0.5

4.6278
0.5

4.6230
0.5

4.2980
0.5

5.4653
0.5

71.56

75.00

76.58

72.32

88.68

81.76
77.43

85.14
80.86

83.56
80.54

86.67
80.53

90.28
89.60

DISCUSSION
Despite low error rates, some clarification on the LAW and LAL measurements

may help inexperienced observers. Because it can be difficult to hold a single

calcaneus in exact anatomical position when in isolation, the exact points from which

to measure are not always clear.

The present project had very similar results to the study done by DiMichele

and Spradley (2012), with high accuracy rates and similar sectioning points.

However, as shown in other studies (Lee et. al, 2012; Bethard & Seet, 2013), metric

methods of sex estimation tend to be population specific. While these sectioning

points are accurate for majority-white American skeletal populations, they may not be

accurate for individuals of other ancestral groups or from different geographic

regions. In the contexts of American forensic anthropology, future studies should look

toward developing standards for other demographics commonly found in the United

States.

Sex Estimation Using the Calcaneus – Wharton 18

The univariate equations also provided high overall accuracy rates. Since

those and the sectioning points only require one simple measurement, these are the

preferred methods compared to using a multivariate equation. While the calcaneus
may often be present in archaeological settings (Waldron, 1987), it may also be

damaged or broken, making it more difficult to get all four measurements needed for a
multivariate equation.

CONCLUSION
This study validates the findings of DiMichele and Spradley (2012), and

demonstrates that the calcaneus is sexually dimorphic and produces high

classifications for sex estimation in a modern American skeletal population.

Like many authors have done in the past, future studies could focus on more

measurements of the calcaneus to determine which metric(s) are the most useful in

estimating sex regardless of ancestry or for different ancestral groups/populations.

Additionally, it may be useful to look into what causes the misclassifications of sex.

Differences in calcaneal metrics could be caused by a variety of factors including body
weight, lifestyle, whether an individual overpronates or oversupinates, or has had a

foot injury. Further, more advanced techniques may be necessary to determine what

can affect sex estimation with the calcaneus.

Sex Estimation Using the Calcaneus – Wharton 19

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