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Bestimmung des Skelettalters

Vergleich der Methoden nach Greulich und Pyle sowie Tanner und Whitehouse

Determination of skeletal age

Comparison of the methods of Greulich and Pyle and Tanner and Whitehouse

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Zusammenfassung

Hintergrund

Hauptziel dieser Studie ist es, die Genauigkeit und den Zeitaufwand der Skelettalterbestimmungen (SAB) nach Greulich u. Pyle (GP) sowie Tanner u. Whitehouse (TW) festzustellen, und die täglich praktikable zu bestimmen.

Material und Methode

In die Studie wurden 63 Kinder zwischen 5 und 18 Jahren einbezogen. Alle SAB wurden nach GP und TW anhand von Röntgenbildern der linken Hand im Blindverfahren von 5 bzw. 6 Untersuchern unter Messung der Untersuchungsdauer ausgewertet, diese Prozedur wurde nach 2 Monaten wiederholt.

Ergebnisse

Das mittlere Skelettalter (SA) wurde nach GP leicht zu niedrig eingeschätzt, nach TW zu hoch. Die mittleren Abweichungen zwischen den Ergebnissen von je 2 Untersuchern waren nach GP tendenziell niedriger. Wiederholte SAB durch den gleichen Untersucher wichen nur geringfügig voneinander ab. Die erforderliche Untersuchungszeit nach GP betrug weniger als die Hälfte als nach TW. Eine Steigerung der Genauigkeit der SAB bei der 2. Anwendung konnte nur für die Methode nach GP nachgewiesen werden.

Schlussfolgerung

Keine der beiden hier verwendeten Methoden ist der anderen deutlich überlegen. Im klinischen Alltag ist der Gebrauch der SAB-Methoden nach GP praktikabler.

Abstract

Purpose

The main purpose of this study was to evaluate the accuracy and the time required to determine skeletal age (SA) in healthy children by the methods of Greulich and Pyle (GP) and of Tanner and Whitehouse (TW). Based on these results recommendations for routine clinical practice is to be established.

Materials and methods

In this study a total of 63 children between the ages of 5 and 18 years were included. Each conventional radiographic image of the left hand was assessed under blinded conditions by 5 or 6 examiners and the time needed was recorded. The assessments were repeated after 2 months.

Results

The average chronological age was estimated slightly too low by the GP method and clearly too high by TW. The mean deviation between the results of two examiners tended to be higher with the TW method than with GP. Repeated assessments of SA by the same examiner deviated only slightly for both methods. The time taken to assess the SA by GP was less than half as long as for TW. An improvement in accuracy of SA estimation after repeated use was only observed for GP.

Conclusion

Of the two methods tested neither proved to be superior. Determination of SA by the GP method was found to be more suitable for routine clinical practice.

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Abbreviations

SA:

Skelettalter

SAB:

Skelettalterbestimmung

GP:

Greulich u. Pyle

TW:

Tanner u. Whitehouse

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Authors and Affiliations

  1. Abteilung für Kinderorthopädie, Deformitätenrekonstruktion und Fußchirurgie, Universitätsklinikum Münster, Albert-Schweitzer-Campus 1, 48149, Münster, Deutschland

    M.J. Horter, S. Wacker, B. Vogt, R. Roedl & F. Schiedel

  2. Abteilung für Inneren Medizin, Franziskus-Hospital Bielefeld, Bielefeld, Deutschland

    S. Friesen

  3. Orthopädische Klinik Volmarstein , Wetter/Ruhr, Deutschland

    B. Leidiger

Authors
  1. M.J. Horter
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  2. S. Friesen
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  3. S. Wacker
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  4. B. Vogt
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  5. B. Leidiger
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  6. R. Roedl
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  7. F. Schiedel
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Correspondence to M.J. Horter.

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Horter, M., Friesen, S., Wacker, S. et al. Bestimmung des Skelettalters. Orthopäde 41, 966–976 (2012). https://doi.org/10.1007/s00132-012-1983-y

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