![]() ![]() The individuals in the sample came to the clinic to receive treatment for trauma to the hand or wrist the individuals were in reasonably good health prior to their injury. Although Greulich and Pyle determined adolescence to be between 14 and 18 years, we expanded the range for the current sample as the actual age of skeletal maturation was unknown. The age range of the selected individuals was 13-22 years this range was selected in order to encompass the age of onset of puberty and skeletal maturation. Methodology detailed by Greulich and Pyle 5 was applied and the resulting skeletal age estimate was compared to the chronological age for each individual.Ī sample of 131 pre-existing hand-wrist radiographs of male patients attending the Martin Singer Cape Hand Clinic for treatment was used. ![]() In the present study, we assessed the applicability of the Greulich-Pyle standards to contemporary African male individuals living in South Africa, for the assessment of skeletal maturation as defined by the termination of long bone growth and complete epiphyseal fusion of the bones in the hand and wrist. 7,8,9 These factors influence growth and skeletal development, causing varying effects on different populations, which thereby affect the direct applicability of the Greulich-Pyle standards to various populations. Differences in growth rate and maturation which were noted when the Greulich-Pyle standards were applied to contemporary populations, have been attributed to secular trends and differences in genetic origin, health status and economic status. ![]() 7 Greulich and Pyle's reference population was from the Brush Foundation study carried out from 1931 to 1942. This scepticism is because, by its nature, a standard is based on the results of a specific study performed on a specific population at a specified point in time. The applicability of the Greulich-Pyle standards to populations which differ from their reference population is often questioned. Malina 6 proposed that the Greulich-Pyle 5 method is appropriate because it has a low systematic error and its application is simple, relative to individual bone methods. The most commonly used standards are those published in the Radiographic atlas of skeletal development of the hand and wrist by Greulich and Pyle 5. 1,2,3,4 These assessments involve comparing the skeletal age of a test population against established standards. The estimation of skeletal age is a means of assessing development and the process of skeletal maturation in children and adolescents for clinical or forensic purposes. Formulation of skeletal age estimation standards specific to South African populations is therefore recommended. The Greulich-Pyle method showed high precision but low accuracy and was therefore not directly applicable to African male individuals. Thus skeletal maturation was still in progress in a large proportion of the 20- and 21-year-old individuals in our study. Skeletal maturity as characterised by complete epiphyseal fusion occurred approximately 2.1 years later than Greulich and Pyle's estimate of 19 years. The Greulich-Pyle method underestimated skeletal age for approximately 74% of the sample and overestimated skeletal age for 26% of the sample. Skeletal age was on average approximately 6 months younger than chronological age. Estimated skeletal age was compared to the known chronological age for each radiograph. We therefore estimated the skeletal age of 131 male Africans aged between 13 and 21 years, using the Greulich-Pyle method which we applied to pre-existing hand-wrist radiographs. Although they have been widely tested, the applicability of these standards to contemporary populations has yet to be tested on a population of African biological origin living in South Africa. These standards are based on the assumption that skeletal maturity in male individuals is attained by the chronological age of 19 years. The skeletal age of a test population is estimated by comparison with established standards, the most common standards being those in the Radiographic atlas of skeletal development of the hand and wrist published by Greulich and Pyle in 1959. Skeletal age estimation as a means of assessing development and skeletal maturation in children and adolescents is of great importance for clinical and forensic purposes. Is Greulich-Pyle age estimation applicable for determining maturation in male Africans?ĭepartment of Human Biology, University of Cape Town, Cape Town, South Africa ![]()
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