DIFFERENCES IN SKELETAL MATURITY LEVELS BETWEEN THE KNEE AND HAND

The skeletal maturity levels of the knee and hand were compared in 245 normal and 100 anisomelic children ages 6 and 15 years. The median levels of maturity in the areas studied were close to those of the atlas standards at corresponding chronologic ages. The fiftieth percentiles of the differences between the knee, femur or the tibia and the hand were close to zero for most age-specific and sex-specific comparisons in the normal children, but there was a wide range of differences in each group. There was a tendency for the femur to be less mature than the tibia and in some children the lateral and medial condyles of the femur and tibia differed in skeletal maturity levels. Similar differences occurred in the anisomelic children; there was only a slight tendency for the knee on the abnormal side to be less mature than the normal knee. In both groups of children, the distributions of differences were similar whether the hand skeletal ages were calculated including or excluding the carpals.

Usually mature stature and the effect of epiphysiodesis on skeletal elongation are predicted from the skeletal maturity of the hand, although biologically skeletal maturity of the knee would be preferable. The regional differences in skeletal maturity levels found during the present investigation could be one source of the errors of prediction that occur.

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