Skeletal stages of the hand and wrist as indicators of the pubertal growth spurt.

Longitudinal data on adolescent growth in height and skeletal development of the hand and wrist were collected as part of a prospective study of the growth and development of 212 randomly selected Swedish urban children. The onset, peak and end of the pubertal growth spurt were defined on the unsmoothed incremental curve of height. The skeletal development was evaluated by studying the attainment of specified stages of the ulnar sesamoid of the metacarpophalangeal joint of the first finger, the epiphyses of the middle and distal phalanges of the third finger and the distal epihysis of the radius. All growth events and skeletal stages occurred earlier in girls than in boys. At the peak of the pubertal growth spurt the skeletal development was more advanced in girls than in boys, but at the end of the spurt the girls had a less mature skeletal development than the boys. The analysis of the relationship in time between the growth events and the skeletal stages showed that these stages can be used to indicate which period of adolescent growth an individual has reached.