幼儿手腕骨发育长期变化的研究

Study on secular growth change of hand wrist maturation in children

目的探讨近20年来幼儿手腕骨发育的长期变化程度,为更精确地判定手腕骨骨龄提供依据。方法对1980年和2004年3-6岁幼儿手腕骨X线片进行骨发育对比观察,1980年检测哈尔滨市8所幼儿园314名幼儿,2004年又在上述幼儿园检测280名幼儿,采用图谱法和记分法判定骨龄,并统计各腕骨萌出数及顺序,同时观察掌指骨发育正常变异。结果各年龄组男女幼儿的手腕骨中位片骨龄值2004年比1980年高出0.5岁左右:8个性别年龄组中有5组的中位片2004年比1980年多萌出1个腕骨,其他3组虽腕骨数相同,但2004年中位片腕骨形态较大;2004年观察的幼儿小指中节骨短小检出率有所降低。结论近20年来3-6岁幼儿的手腕骨发育有所提前;制订和运用骨龄标准时应考虑这一影响因素。

Objective To study the secular growth change of hand wrist maturation of local children in the past 20 years, in order to provide scientific criteria for accurate assessment of the skeletal age of hand wrist maturation. Methods Hand wrist X ray films of 3 - 6 years old children taken from 1980 and ones from 2004 were collected and analyzed comparatively on skeletal maturation. Totally, 314 children from 8 kindergartens in Harbin were examined in 1980, and 280 children from the same 8 places were examined in 2004. Atlas and counting methods were deployed to judge the skeletal age, and the numbers of carpal germinated as well as the budding order were also counted. Normal variation of metacarpi and phalanx maturation were observed. Results The skeletal age of hand wrist bones shown on the medium X ray films in 2004 was 0. 5 year earlier than that in 1980 among different gender age children. Among 8 gender age groups, 5 of them in 2004 were found to have one more carpal than that in 1980. Even though the numbers of appearance of carpal were the same among other 3 groups, the carpal shape in 2004 was bigger than that in 1980. The detectable rate of shortening in middle phalanx V among children in 2004 decreased. Conclusions The hand wrist maturation of 3 - 6 years old children in Harbin is ahead of their age during the past 20 years, which should be taken into consideration when setting up and applying the criteria of skeletal age.