Related Experiment Videos
Growth and predictions of growth in the upper extremity
1Department of Orthopaedic Surgery, University of Washington, Seattle.
Insights
This study tracked upper extremity growth in children, finding predictable bone lengthening patterns. These findings aid in forecasting growth discrepancies and timing interventions for limb equalization.
Area of Science:
- Pediatric orthopedics
- Human growth and development
- Biostatistics
Background:
- Understanding pediatric bone growth is crucial for diagnosing and managing limb length discrepancies.
- Previous studies have provided general growth charts, but precise data for the upper extremity from childhood to skeletal maturity is less defined.
Purpose of the Study:
- To establish precise growth data for the humerus, radius, and ulna in children from age seven to skeletal maturity.
- To provide a basis for accurate prediction of upper extremity growth and potential discrepancies.
- To inform the optimal timing for surgical or non-surgical equalization procedures.
Main Methods:
- Longitudinal study involving teleroentgenograms of the upper extremities of 244 children (123 boys, 121 girls).
- Measurements of humerus, radius, and ulna lengths were taken at six-month intervals until skeletal maturity.
- Analysis focused on proportional changes and annual growth rates of the long bones.
Main Results:
- Upper and lower arm proportions remain relatively stable after age seven.
- Humerus length as a percentage of standing height increases slightly with age in both sexes.
- Specific annual growth rates were determined for the humerus, radius, and ulna in boys and girls.
Conclusions:
- The established growth data allows for accurate prediction of future upper extremity length and identification of potential growth discrepancies.
- Precise growth remaining at the growth plates of the humerus, radius, and ulna can be calculated.
- These predictions can lead to more precise timing for interventions aimed at limb length equalization.
Abstract:
Teleroentgenograms of the upper extremity in 244 children (123 boys and 121 girls) were made at six-month intervals from the age of seven to the time of skeletal maturity. Lengths were measured to determine the growth remaining at both growth plates of the humerus, radius, and ulna. The subjects were healthy, well nourished, middle-class Americans, mostly of northwest European descent. After the age of seven, the proportion between the upper and lower arms does not change appreciably. The humerus is 18 per cent of standing height in girls at the age of seven and 19 per cent at the age of fifteen. In boys, the humerus is 18 per cent of standing height at the age of seven and 20 per cent at the age of seventeen. The length of the radius is 13 per cent of standing height in girls at the age of seven, increasing to 14 per cent by skeletal maturity. In boys, the length of the radius increases from 14 per cent of standing height at the age of seven to 15 per cent at skeletal maturity. From the age of seven to skeletal maturity, the humerus grows approximately 1.2 centimeters in girls and 1.3 centimeters in boys each year. In girls, the ulna grows approximately 1.0 centimeter and the radius, 0.9 centimeter each year after the age of seven. In boys, the ulna grows approximately 1.1 centimeters and the radius, approximately 1.0 centimeter each year from the age of seven to skeletal maturity. Based on these data, accurate predictions of growth and of growth discrepancy in the upper extremity can be made, and the time at which to perform equalization procedures can be determined more precisely.