Skeletal maturation of the human fetus assessed radiographically on the basis of ossification sequences in the hand and foot

Abstract

In studies of postnatal human development the skeletal maturation of the hand has been found to be a better indicator of general physical maturation than attained body height. For assessment of prenatal human development the Crown‐rump length (CRL) has so far been the most commonly used measure. The object of the present study is to examine the possibility of also using the skeletal maturation of the hand as a maturity indicator in fetal development. The study is based upon a radiographic and histochemical investigation of 169 human fetuses. On the basis of counting silver‐impregnated diaphyses on radiographs of the hand and foot a maturity indicator (CNO = Composite Number of Ossified bones in hand and foot) was established. Owing to the marked regularity of the recorded ossification pattern, the CNO parameter can be used for evaluating fetal maturation during the early half of the prenatal period. To supplement the assessment of skeletal maturation during the later stages of development, a classification based on the shape of some bones was included in the study. In many cases fetuses of the same size (CRL) exhibited different stages of skeletal maturation (CNO). In accordance with findings from assessment of postnatal development, a more accurate evaluation of fetal development is obtained by combining the size parameter CRL with an assessment of fetal skeletal maturation, CNO.

Estimation of Gestational and Skeletal Age in Macaco mulatta

“…The ossification and fusion of carpal and metacarpal bones prove to be among the most accurate criteria. Data obtained from human material, compiled into the atlas containing reference standards (13,17,25) and age indicators, have been used for many years in pediatric and forensic medicine.…”

Fetal age: Methods of estimation and effects of pathology

“…The first is appearance of ossification centers (e.g., Hill, 1939;Gruelich and Pyle, 1950;Noback, 1954;Garn et al, 1967Garn et al, , 1972Kjar 1974;Pryse-Davies et al, 1974;O'Rahilly and Gardner, 1996). Such estimates are usually given as the minimal time of first appearance for specific centers or based on the total number of centers present.…”

Tubular hand bone growth during the latter half of the prenatal period: An allometric analysis

“…The high CY values for the middle phalanges may be associated with the relatively slow growth rate of the middle phalangeal lengths in the early prenatal period HAND BONE GROWTH ~~n i i r u PRENATAL PERIOD (Garn et ai., 1975) and the delayed appearance of the ossification center of these bones (Kjar, 1974;Mall, 1906;Noback and Robertson, 1951). Thus, catch-up growth of the ossified shaft as well as the whole bone may be taking place after the delayed bone formation.…”

“…Likewise, fetal hand bones have been studied with both radiographs (Hill, 1939;Kjar, 1974;Mall, 1906) and histological sections (Burdi et al, 1979;Garn et al, 1975;Kraus and Choi, 1958).…”