- Discussion:
- growth-remaining method
- straight-line graph method
- arithmetic method is the simplest, but least accurate.
- proximal femoral physis::
- 4 mm / yr (1/8 in/yr)
- distal femoral physis:
- 10 mm / yr (3/8 in/yr)
- contributes to 70% of femoral growth or 54% of lower limb growth;
- proximal tibial physis:
- 6 mm / yr (1/4 in/yr)
- contributes to 60% of tibia growth or 46% of limb growth;
- distal tibial physis:
- 5 mm / yr (3/16 in/yr)
- total adult height = Ht. at age 2 x 2
- growth ceases: 14 - 15 yrs in girls
16 - 17 yrs for boys
- Menelaus method:
- calculate current discrepancy
- calculate the change in discrepancy per year
- calculate the time remaining for growth (girls: 14 - current, boys: 16- current)
- calculate the discrepancy at maturity: (current discrepancy + (years remaining * discrepancy per year))
- Muliplier Method:
- Multiplier method for predicting limb-length discrepancy.
- Clinical validation of the multiplier method for predicting limb length at maturity, part I.
- Clinical Validation of the Multiplier Method for Predicting Limb Length Discrepancy and Outcome of Epiphysiodesis, Part II.
- The multiplier method for prediction of adult height.
A graphic method for timing the correction of leg-length discrepancy.
Deficiencies of current methods for the timing of epiphysiodesis.
The accuracy of current methods in determining the timing of epiphysiodesis
- contributions to growth of each plate in each of the long bones:
proximal humerus:......80%
distal humerus:............20%
proximal radius:..........25%
distal radius:................75%
proximal ulna:.............20%
distal ulna:...................80%
proximal femur:...........30%
distal femur:.................70%
proximal tibia:..............57%
distal tibia:....................43%
proximal fibula:............60%
distal fibula:..................40%