Unaccompanied foreign minors: the Novara experience as a hub center of Eastern Piedmont (Italy)

Approximately 20% of migrants arriving in Italy are Unaccompanied Foreign Minors (UFMs) whose right to remain in the EU depends on age assessment whenever their chronological age is doubted. This cross-sectional study evaluated the validity of the multidimensional protocol used by the 'Maggiore della Carità' Hospital in Novara (the reference center for Eastern Piedmont) by analyzing the forensic reports of 301 self-proclaimed minors (97% male; mean self-reported age: 16.32 ± 1.35 years) examined between 2018 and 2023. Results showed a mean age estimated via wrist X-ray of 17.81 ± 1.52 years and a weak statistical correlation (r = 0.36) between sexual maturation and bone age; notably, no migrant was certified as an adult, while pathologies and injuries were frequently documented. Comparison with European data suggests that despite being one of Italy’s most comprehensive frameworks, the Piedmontese protocol exhibits limitations in accurate chronological estimation. This highlights the urgent need for standardized, concrete assessment methodologies that safeguard minors' rights while strictly respecting their psycho-physical integrity.