Evaluación de la maduración ósea mediante radiografía del carpo en niños y adolescentes afro-colombianos de Puerto Tejada, Cauca, 2007 / Assessment of the skeletal maturation through hand wrist radiographies in Afro-Colombian children, from Puerto Tejada, Cauca, 2007

Introducción: El objetivo del estudio fue determinar la edad por el esqueleto (niveles de maduración ósea) en niños y niñas de ascendencia continental africana (afrocolombianos) de 8 a 14 años de edad del municipio de Puerto Tejada, Cauca. Materiales y Métodos: Investigación de corte transversal; en la cual se tomaron Radiografías de Mano-Muñeca a 80 niños y niñas en las dos manos, aplicando el análisis de Bjõrk. Resultados: El 50% de los participantes fueron de género masculino. El 57% de la muestra se encontró en dentición mixta tardía. De acuerdo al estadío de maduración ósea, el 36.7% se encontró en PP2 (ancho igual de diáfisis y epífisis de la falange proximal del dedo índice); 18.2% en MP3 (ancho igual de diáfisis y epífisis de la segunda falange del dedo medio). El mayor estadío alcanzado por los niños fue MP3cap mientras que las niñas presentaron el máximo estadio de desarrollo Ru, es decir completaron el crecimiento. Discusión: Lamparsky en 1972, García Fernández en 1998, Román en 2002 y Soegiharto en 2008 reportaron variación en la maduración ósea de acuerdo a la raza, coincidiendo con los resultados del presente estudio. Conclusiones: Existen diferencias en el nivel de maduración de acuerdo al género y la raza, observándose que las niñas afrocolombianas maduran más rápido que los niños. Estas diferencias deben ser consideradas durante el diagnostico y el plan de tratamiento ortopedico maxilar, ortodontico y en medicina general.

Introduction: The aim of this study was to determine the skeletal age measurement (stages of skeletal maturity) of African continental ancestry (Afro Colombians) in boys and girls from 8 to 14 years of Puerto Tejada, Cauca. Material and Methods: this cross-sectional study examined X-rays of both hands and wrists obtained from 80 boys and girls using Bjõrks analysis to evaluate the stage of skeletal maturity. Results: 50% of participants were male gender. 57% of the sample was found with late mixed dentition. According to stage of osseous maturity, 36.7% of subjects were classified in PP2 (equal width of diaphysis and epiphyses of the proximal phalanx of index finger); 18.2% in MP3 (diaphysis and epiphyses with the same width of the second half phalanx of finger). The more maturity stage reached by boys was MP3cap while girls showed the highest stage of development Ru, which is complete growth. Conclusions: There are differences in the level of maturation according to the gender and race, observing that the Afro Colombian girls mature faster than boys. These differences must be considered during diagnosis and treatment planning in maxillary orthopedic, orthodontics and general medicine.

Verification of the Reliability of Sagittal MR Images in Assessment of Segmental Instability of the Wrist

PURPOSE: To determine the reliability of carpal angle measurement using sagittal wrist MR images for thediagnosis of dorsal intercalated segmental instability (DISI) or ventral intercalated segmental instability(VISI). MATERIALS AND METHODS: In ten asymptomatic adult volunteers, capitolunate, scapholunate, and radiolunate angleswere measured on lateral radiographs and five different series of sagittal MR images, and compared andstatistically analysed. The four MR series, obained in a prone position, with the wrists over the head, were asfollows : A, sagittal images parallel to the third metacarpal bone axis, in a neutral position ; B, obliquesagittal images parallel to the fourthe metacarpal axis, in a neutral position, ; C and D, sagittal imagesparallel to the third metacarpal bone axis, with the wrist at 15degree radially and ulnarly deviated positions,respectively. The fifth true sagittal MR image (E) was obtained in a supine position with the wrists locatedbeside the trunk, in a neutral position. RESULTS: In the MR series performed in the prone position, thecapitolunate and radiolunate angles measured in the series A, B and D were significantly larger than those seen onlateral radiographs. The scapholunate angle showed a statistically significant difference(p=.014) in series D,where one case showed DISI configuration at a scapholunate angle of 81degree. In other series, the angles were notsignificantly different from those seen on lateral radiographs. CONCLUSION: The lunate appears more dorsallytilted on sagittal MR images obtained in the prone position with the wrists above the head than on lateralradiographs, and a DISI configuration can be minicked. IF diagnosing wrist segmental instability by interpretingsagittal MR images without lateral radiographs, there is potential risk of misdiagnosis. It is believed that wristpositioning is crucial for the correct measurement of angles.