Minor skeletal variants in the hand
Autores: Dini Elizabeth1, Macías-Tomei Coromoto2, González Carolina1
Título: Minor skeletal variants in the hand
Referencia: X International Congress of Auxology 4-7 julio 2004
The prevalence of minor skeletal variants (MSV) is influenced by different factors, one of which is the age of the diagnosis. The objective of this research was to evaluate the evolution of the MSV: pseudoepiphyses, brachymesophalangy, cone-shaped epiphyses, and supernumerary epiphyses in malnourished children and adolescents without growth primary deficit, of both sexes, and between 2 and 6 years of age. Out of 973 radiographs of left hands and wrists with MSV diagnosed between 1995 and 1998, 134 were selected to follow their evolution [84 boys (62.7%) and 50 girls (37.3%)] until the year 2003. The first radiograph performed on each child was considered, as well as any which showed any change in appearance or disappearance of any MSV. The maturation rhythm was determined with the skeletal age (TW2 method) and its location in percentiles of national reference. The radiographs were classified in 4 age groups: 2-4 years, 5-7, 8-10, 11-13, and 14 upward. MSV were categorized in 6 groups: pseudoepiphyses of the first metacarpal, pseudoepiphyses of metacarpals 2, 3, 4, and 5 and thumb proximal and distal phalanges, pseudoepiphyses of the middle phalanx of the fifth finger, brachymesophalangy, cone-shaped epiphyses, and supernumerary epiphyses. Descriptive statistics, Rao-Scott corrected chi-square test, and the Binary Correspondence with concatenated tables were calculated with the use of a graphic device (projection plan) which represents the profiles of the modalities of two variables (age and MSV)); significance level p< 0.05. Significant association was found between age groups and MSV (X2c = 442.13) for the first radiographs, and (X2c = 230.69) for the second radiographs. Distribution maps and graphs made it possible to observe that the age groups with higher concentration of MSV were those between 5-7 and 8-10 years in both radiographs. The pseudoepiphyses of the first metacarpal and the pseudoepiphyses of metacarpals 2, 3, 4, and 5 and proximal and distal phalanges of the thumb prevailed between the ages 2-11, descending from this age on, and the pseudoepiphyses of the middle phalanx of the fifth finger from 5 to 12 years. The brachymesophalangy were seen throughout all of the age groups; the cone-shaped epiphyses were found from 4-11 years, markedly decreasing after this age, and the supernumerary epiphyses were seen in the 2-4 age group. There were no differences for the maturation rhythm. These results help identify the age ranges in which each of these MSV are observed.
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