Brenneis Marco, Thewes Niklas, Holder Jana, Stief Felix, Braun Sebastian
Department of Orthopedics (Friedrichsheim), University Hospital, Goethe University Frankfurt, Frankfurt, Germany.
Department of Sport and Exercise Science, University of Salzburg, Salzburg, Austria.
Bone Jt Open. 2023 Oct 10;4(10):750-757. doi: 10.1302/2633-1462.410.BJO-2023-0105.R1.
Accurate skeletal age and final adult height prediction methods in paediatric orthopaedics are crucial for determining optimal timing of growth-guiding interventions and minimizing complications in treatments of various conditions. This study aimed to evaluate the accuracy of final adult height predictions using the central peak height (CPH) method with long leg X-rays and four different multiplier tables.
This study included 31 patients who underwent temporary hemiepiphysiodesis for varus or valgus deformity of the leg between 2014 and 2020. The skeletal age at surgical intervention was evaluated using the CPH method with long leg radiographs. The true final adult height (FH) was determined when the growth plates were closed. The final height prediction accuracy of four different multiplier tables (1. Bayley and Pinneau; 2. Paley et al; 3. Sanders - Greulich and Pyle (SGP); and 4. Sanders - peak height velocity (PHV)) was then compared using either skeletal age or chronological age.
All final adult height predictions overestimated the FH, with the SGP multiplier table having the lowest overestimation and lowest absolute deviation when using both chronological age and skeletal age. There were no significant differences in final height prediction accuracy between using skeletal age and chronological age with PHV (p = 0.652) or SGP multiplier tables (p = 0.969). Adult height predictions with chronological age and SGP (r = 0.769; p ≤ 0.001), as well as chronological age and PHV (r = 0.822; p ≤ 0.001), showed higher correlations with FH than predictions with skeletal age and SGP (r = 0.657; p ≤ 0.001) or skeletal age and PHV (r = 0.707; p ≤ 0.001).
There was no significant improvement in adult height prediction accuracy when using the CPH method compared to chronological age alone. The study concludes that there is no advantage in routinely using the CPH method for skeletal age determination over the simple use of chronological age. The findings highlight the need for more accurate methods to predict final adult height in contemporary patient populations.
在小儿骨科中，准确的骨骼年龄和最终成人身高预测方法对于确定生长引导干预的最佳时机以及将各种病症治疗中的并发症降至最低至关重要。本研究旨在评估使用长腿X线片的中央峰值高度（CPH）方法和四个不同的乘数表预测最终成人身高的准确性。
本研究纳入了2014年至2020年间因腿部内翻或外翻畸形接受临时半骨骺阻滞术的31例患者。手术干预时的骨骼年龄采用CPH方法结合长腿X线片进行评估。当生长板闭合时确定真实的最终成人身高（FH）。然后使用骨骼年龄或实足年龄比较四个不同乘数表（1. 贝利和皮诺；2. 佩利等人；3. 桑德斯 - 格鲁利希和派尔（SGP）；4. 桑德斯 - 峰值身高速度（PHV））的最终身高预测准确性。
所有最终成人身高预测均高估了FH，在使用实足年龄和骨骼年龄时，SGP乘数表的高估程度最低且绝对偏差最小。使用骨骼年龄和实足年龄结合PHV（p = 0.652）或SGP乘数表（p = 0.969）时，最终身高预测准确性无显著差异。实足年龄与SGP（r = 0.769；p≤0.001）以及实足年龄与PHV（r = 0.822；p≤0.001）的成人身高预测与FH的相关性高于骨骼年龄与SGP（r = 0.657；p≤0.001）或骨骼年龄与PHV（r = 0.707；p≤0.001）的预测。
与单独使用实足年龄相比，使用CPH方法时成人身高预测准确性没有显著提高。该研究得出结论，常规使用CPH方法确定骨骼年龄相较于简单使用实足年龄并无优势。研究结果凸显了在当代患者群体中需要更准确的方法来预测最终成人身高。
