Skip to main content

Advertisement

Log in

Usefulness of the Sauvegrain Method of Bone Age Assessment in Indian Children

  • Original Article
  • Published:
Indian Journal of Orthopaedics Aims and scope Submit manuscript

Abstract

Introduction

Bone age estimation is very useful in children undergoing epiphysiodesis or guided growth surgery especially during the years of accelerated growth. It may be noted that no data are available on bone age estimation for Indian children of this age group. Sauvegrain (French) method is a very useful and simple method for bone age assessment during the years of accelerated growth. We decided to check the usefulness and the accuracy of the Sauvegrain method in Indian children.

Materials and methods

A team of two pediatric orthopaedic surgeons and a radiologist scored elbow X-rays of 80 healthy children (40 boys and 40 girls), using the Sauvegrain method twice. Interobserver reliability and intraobserver reproducibility of the Sauvegrain scoring were assessed.

Results

There was a very strong correlation between all observers in both rounds (r = > 0.8) and an excellent reproducibility by the same observer in both rounds (r = 0.955). Chronological and bone age are considered the same if the difference between them is less than 6 months. With this criterion bone and chronological ages matched in > 37% of boys and girls, similar to the study done in French children. In the nonmatching group, more children had delayed bone age compared to their chronological age.

Conclusion

The Sauvegrain method of bone age assessment described for French children was found to be useful in estimating bone age in Indian children. It is especially helpful in the clinical practice for detecting mismatch between the chronological and the radiological age before undertaking guided growth or epiphysiodesis.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Chart 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5

Similar content being viewed by others

References

  1. Lee, S. C., Shim, J. S., Seo, S. W., Lim, K. S., & Ko, K. R. (2013). The accuracy of current methods in determining the timing of epiphysiodesis. The Bone and Joint Journal, 95B(7), 993–1000. https://doi.org/10.1302/0301-620X.95B7.30803.

    Article  Google Scholar 

  2. Westh, R. N., & Menelaus, M. B. (1981). A Simple Calculation for the Timing of Arrest. The British Editorial Society of Bone & Joint Surgery, 63(1), 117–119.

    Article  Google Scholar 

  3. Anderson, M., Green, W. T., & Messner, M. B. (1963). Predictions of Growth in the Lower Extremities. JBJS, 45(1), 1963.

    Article  Google Scholar 

  4. Moseley, C. F. (1978). A straight line graph for leg length discrepancies. Clinical Orthopaedics and Related Research, 136, 33–40. https://doi.org/10.1097/00003086-197810000-00004.

    Article  Google Scholar 

  5. D. Paley, A. Bhave, J. E. Herzenberg, and J. R. Bowen, Multiplier Method for Predicting Limb-Length Discrepancy Multiplier Method for, 2007.

  6. Zajonz, D., et al. (2017). Treatment of genu valgum in children by means of temporary hemiepiphysiodesis using eight-plates: Short-term findings. BMC Musculoskeletal Disordorder, 18(1), 1–8. https://doi.org/10.1186/s12891-017-1823-7.

    Article  Google Scholar 

  7. Sawiris, Y. A., Abo-Seif, S., & Aly, A. S. (2018). The Using of ‘Guided Growth’ for Correction of Coronal Deformities around the Knee in Skeletally Immature Children (Systematic review and Metaanalysis). Medical and Clinical Review, 04(03), 1–10. https://doi.org/10.21767/2471-299x.1000073.

    Article  Google Scholar 

  8. Stevens, P. M. (2006). Guided growth: 1933 to the present. Strategies in Trauma and Limb Reconstruction, 1(1), 29–35. https://doi.org/10.1007/s11751-006-0003-3.

    Article  PubMed Central  Google Scholar 

  9. P. S. Greulich WW, Radiographic Atlas of Skeletal Development of the Hand and Wrist, 2nd ed. Stanford University PressPalo Alto, 1959.

  10. Fishman, L. S. (1982). Radiographic evaluation of skeletal maturation. A clinically oriented method based on hand-wirst films. Angle Orthodontist, 52(2), 88–112. https://doi.org/10.1043/0003-3219(1982)052<0088:REOSM>2.0.CO;2.

    Article  CAS  Google Scholar 

  11. Acheson, R. M. (1957). The Oxford method of assessing skeletal maturity. Clinical Orthopaedics and Related Research, 10, 19–39.

    CAS  Google Scholar 

  12. Sauvegrain, B. H., & Nahum, J. H. (1962). Study of bone maturation of the elbow. Annals de Radiologie, 5, 542–550.

    CAS  Google Scholar 

  13. Charles, Y. P., Diméglio, A., Canavese, F., & Daures, J. P. (2007). Skeletal age assessment from the olecranon for idiopathic scoliosis at risser grade 0. Journal of Bone and Joint Surgery Series A, 89A(12), 2737–2744. https://doi.org/10.2106/JBJS.G.00124.

    Article  Google Scholar 

  14. A. Dimeglio, Growth in pediatric orthopaedics. Journal of Pediatric Orthopaedics, vol. 21, no. 4, pp. 549–55, 2001, [Online]. Available: https://www.ncbi.nlm.nih.gov/pubmed/11433174.

  15. Heyworth, B. E., et al. (2013). The shorthand bone age assessment: A simpler alternative to current methods. Journal of Pediatric Orthopedics, 33(5), 569–574. https://doi.org/10.1097/BPO.0b013e318293e5f2.

    Article  PubMed  Google Scholar 

  16. Tanner, J. M., Whitehouse, R. H., Marshall, W. A., & Carter, B. S. (1975). Prediction of adult height from height, bone age, and occurrence of menarche, at ages 4 to 16 with allowance for midparent height. Archives of Disease in Childhood, 50(1), 14–26. https://doi.org/10.1136/adc.50.1.14.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  17. Little, D. G., Nigo, L., & Aiona, M. D. (1996). Deficiencies of current methods for the timing of epiphysiodesis. Journal of Pediatric Orthopedics, 16(2), 173–179. https://doi.org/10.1097/01241398-199603000-00007.

    Article  CAS  PubMed  Google Scholar 

  18. Eastwood, D. M., & Sanghrajka, A. P. (2011). Guided growth: Recent advances in a deep-rooted concept. Journal of Bone and Joint Surgery Series B, 93B(1), 12–18. https://doi.org/10.1302/0301-620X.93B1.25181.

    Article  Google Scholar 

  19. Mohanty, I., & Gebremedhin, T. A. (2018). Maternal autonomy and birth registration in India: Who gets counted? PLoS ONE, 13(3), 1–19. https://doi.org/10.1371/journal.pone.0194095.

    Article  CAS  Google Scholar 

  20. Peters, H., & Shrikande, S. M. (1957). Age at menarche in Indian women. Fertility and Sterility, 8(4), 355–361. https://doi.org/10.1016/s0015-0282(16)32765-0.

    Article  CAS  PubMed  Google Scholar 

  21. Khadgawat, R., et al. (2016). Age of onset of puberty in apparently healthy school girls from northern India. Indian Pediatrics, 53(5), 383–387. https://doi.org/10.1007/s13312-016-0857-5.

    Article  PubMed  Google Scholar 

  22. Pathak, P. K., Tripathi, N., & Subramanian, S. V. (2014). Secular trends in menarcheal age in India-evidence from the Indian Human Development Survey. PLoS ONE. https://doi.org/10.1371/journal.pone.0111027.

    Article  PubMed  PubMed Central  Google Scholar 

  23. Hassel, B., & Farman, A. G. (1995). Skeletal maturation evaluation using cervical vertebrae. American Journal of Orthodontics and Dentofacial Orthopedics, 107(1), 58–66. https://doi.org/10.1016/S0889-5406(95)70157-5.

    Article  CAS  PubMed  Google Scholar 

  24. Cundy, P., Paterson, D., Morris, L., & Foster, B. (1988). Skeletal age estimation in leg length discrepancy. Journal of Pediatric Orthopaedics, 8(5), 513–515. https://doi.org/10.1097/01241398-198809000-00002.

    Article  CAS  PubMed  Google Scholar 

  25. Keny, S. M., et al. (2018). Comparison of two radiological methods in the determination of skeletal maturity in the Indian pediatric population. Journal of Pediatric Orthopaedics Part B, 27(4), 362–365. https://doi.org/10.1097/BPB.0000000000000475.

    Article  PubMed  Google Scholar 

  26. Mansourvar, M., et al. (2014). The applicability of Greulich and Pyle atlas to assess skeletal age for four ethnic groups. Journal of Forensic and Legal Medicine, 22, 26–29. https://doi.org/10.1016/j.jflm.2013.11.011.

    Article  PubMed  Google Scholar 

  27. Zafar, A. M., Nadeem, N., Husen, Y., & Ahmad, M. N. (2010). An appraisal of greulich-pyle atlas for skeletal age assessment in Pakistan. The Journal of the Pakistan Medical Association, 60(7), 552–555.

    PubMed  Google Scholar 

  28. Mughal, A. M., Hassan, N., & Ahmed, A. (2014). The applicability of the Greulich & Pyle Atlas for bone age assessment in primary school-going children of Karachi, Pakistan. Pakistan Journal of Medical Sciences, 30(2), 409–412. https://doi.org/10.12669/pjms.302.4296.

    Article  Google Scholar 

  29. Patil, S. T., Parchand, M. P., Meshram, M. M., & Kamdi, N. Y. (2012). Applicability of Greulich and Pyle skeletal age standards to Indian children. Forensic Science International, 216(1–3), 200.e1–200.e4. https://doi.org/10.1016/j.forsciint.2011.09.022.

    Article  Google Scholar 

  30. Mohammed, R. B., Rao, D. S., Goud, A. S., Sailaja, S., Thetay, A. A. R., & Gopalakrishnan, M. (2015). Is Greulich and Pyle standards of skeletal maturation applicable for age estimation in South Indian Andhra children? Journal of Pharmacy and Bioallied Science, 7(3), 218–225. https://doi.org/10.4103/0975-7406.160031.

    Article  Google Scholar 

Download references

Acknowledgements

The authors thank Dr Hitesh Chauhan, Dr Hitesh Shah, Dr Rohini Patel and Dr Hiral Naik for their help in preparation of this manuscript.

Funding

We have not received any funding for this project. We or any of our family members have no commercial associations (for example consultancies, stock ownership, equity interest, patent/licensing arrangements, etc.) that might pose a conflict of interest in connection with the submitted article.

Author information

Authors and Affiliations

Authors

Contributions

PN (MS, DNB ortho) (Corresponding author)—study design, performed measurements, prepared manuscript. DG (M S, ortho.)—performed measurements. CB (MD, DNB, DMRE Radio Diagnosis)—performed measurements. KV (MD, MPH, PhD)—performed statistical analysis and helped in manuscript preparation. All the authors have significantly contributed to our paper. We do not have any other disclosures.

Corresponding author

Correspondence to Premal Naik.

Ethics declarations

Conflict of interest

Authors do not have any conflict of interest.

Ethical standard statement

We have obtained an approval from Institutional Review Board. We have taken appropriate consent from the patients for this study which is in accordance with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Naik, P., Ganjwala, D., Bhatt, C. et al. Usefulness of the Sauvegrain Method of Bone Age Assessment in Indian Children. JOIO 55, 116–124 (2021). https://doi.org/10.1007/s43465-020-00189-1

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s43465-020-00189-1

Keywords

Navigation