Skeletal maturation in male elite youth athletes from the Middle East

To examine the timing and intensity of skeletal maturation of the radius-ulna-short (RUS) bones in elite youth Arab athletes.

We compared SuperImposition by Translation And Rotation (SITAR) models with different spline degrees of freedom and transformation expressions to summarize 492 longitudinal measurements for individual RUS bones scores assessed from 99 male academy student-athletes (chronological age range, 11.4 to 18 years; annual screening range, four to seven visits).

The SITAR model with 5 degrees of freedom and untransformed chronological age was superior to the other models. The mean growth curve increased with age and showed a mid-pubertal double-kink at a RUS score of ~600 bone score units (au). The SITAR model revealed a first peak in the skeletal maturation velocity curve of ~206 au·year^-1 occurred at ~13.5 years. The mean age at the second and largest peak occurred at 15.1 years (95% confidence interval [CI], 14.9 to 15.3 years), with the respective estimated peak skeletal ossification rate of 334 au·year^-1 (95% CI, 290 to 377 au·year^-1 ). The mean age at peak height velocity was 13.5 years (95% CI, 13.3 to 13.7 years), with peak height velocity of 10 cm·year^-1 (95% CI, 9.6 to 10.4 cm·year^-1 ).

Application of the SITAR method confirmed two peaks in the skeletal maturation velocity curve, with the second and largest rate of ossification occurring at a relatively later timing of ~1.5 years than the height growth spurt. Knowledge of the RUS bones timing and intensity can be important to advance strategies for athlete performance development purposes.