title: A comparison of the simplified olecranon and digital methods of assessment of skeletal maturity during the pubertal growth spurt.
abstract: Assessment of skeletal age is important in children's orthopaedics. We compared two simplified methods used in the assessment of skeletal age. Both methods have been described previously with one based on the appearance of the epiphysis at the olecranon and the other on the digital epiphyses. We also investigated the influence of assessor experience on applying these two methods. Our investigation was based on the anteroposterior left hand and lateral elbow radiographs of 44 boys (mean: 14.4; 12.4 to 16.1 ) and 78 girls (mean: 13.0; 11.1 to14.9) obtained during the pubertal growth spurt. A total of nine observers examined the radiographs with the observers assigned to three groups based on their experience (experienced, intermediate and novice). These raters were required to determined skeletal ages twice at six-week intervals. The correlation between the two methods was determined per assessment and per observer groups. Interclass correlation coefficients (ICC) evaluated the reproducibility of the two methods. The overall correlation between the two methods was r = 0.83 for boys and r = 0.84 for girls. The correlation was equal between first and second assessment, and between the observer groups (r ≥ 0.82). There was an equally strong ICC for the assessment effect (ICC ≤ 0.4%) and observer effect (ICC ≤ 3%) for each method. There was no significant (p < 0.05) difference between the levels of experience. The two methods are equally reliable in assessing skeletal maturity. The olecranon method offers detailed information during the pubertal growth spurt, while the digital method is as accurate but less detailed, making it more useful after the pubertal growth spurt once the olecranon has ossified.
authors.affiliation: CHU Clermont-Ferrand, Department of Pediatric Surgery, 1 Place Lucie et Raymond Aubrac, 63003 Clermont-Ferrand, France.
authors.forename: F
authors.initials: F
authors.lastname: Canavese
authors.affiliation: Hôpitaux Universitaires de Strasbourg, Department of Spine Surgery, 1 Place de l'hôpital, BP 426, 67091 Strasbourg Cedex, France.
authors.forename: Y P
authors.initials: YP
authors.lastname: Charles
authors.affiliation: Université de Montpellier, Faculty of Medicine, 2 Rue de l'école de Médecine, 34060 Montpellier, France.
authors.forename: A
authors.initials: A
authors.lastname: Dimeglio
authors.affiliation: Hôpitaux Universitaires de Strasbourg, Department of Spine Surgery, 1 Place de l'hôpital, BP 426, 67091 Strasbourg Cedex, France.
authors.forename: S
authors.initials: S
authors.lastname: Schuller
authors.affiliation: CHU Clermont-Ferrand, Department of Pediatric Surgery, 1 Place Lucie et Raymond Aubrac, 63003 Clermont-Ferrand, France.
authors.forename: M
authors.initials: M
authors.lastname: Rousset
authors.affiliation: CHU Clermont-Ferrand, Department of Pediatric Surgery, 1 Place Lucie et Raymond Aubrac, 63003 Clermont-Ferrand, France.
authors.forename: A
authors.initials: A
authors.lastname: Samba
authors.affiliation: CHU Clermont-Ferrand, Biostatistics Unit (DRCI), 58 Rue Montalembert, 63000 Clermont-Ferrand, France.
authors.forename: B
authors.initials: B
authors.lastname: Pereira
authors.affiliation: Hôpitaux Universitaires de Strasbourg, Department of Spine Surgery, 1 Place de l'hôpital, BP 426, 67091 Strasbourg Cedex, France.
authors.forename: J-P
authors.initials: JP
authors.lastname: Steib
mesh_terms: D000293:Adolescent; D000365:Age Determination by Skeleton / Q000379:methods*; D002648:Child; D004551:Elbow Joint / Q000000981:diagnostic imaging / Q000254:growth & development*; D004838:Epiphyses / Q000000981:diagnostic imaging / Q000254:growth & development*; D005260:Female; D006801:Humans; D008297:Male; D056740:Olecranon Process / Q000000981:diagnostic imaging / Q000254:growth & development*; D011627:Puberty; D015203:Reproducibility of Results; D014955:Wrist Joint / Q000000981:diagnostic imaging / Q000254:growth & development*
keywords: Digital method; Olecranon method; Pubertal growth spurt; Skeletal age