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Thread: Growth in Pediatric Orthopaedics

  1. #1
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    Growth in Pediatric Orthopaedics

    I thought this information was very helpful and informative. I am posting if for others to use as there seems to be some misconceptions of how growth of the spine typically occurs in adolescents.

    I am posting a quote out of the Journal of Pediatric Orthopedics entitled Growth in Pediatric Orthopaedics by Alain Dimeglio, M.D.:

    Journal of Pediatric Orthopaedics
    21:549555 2001 Lippincott Williams & Wilkins, Inc., Philadelphia


    Quote:
    During puberty, standing height increases by approximately
    1 cm per month. At the onset of puberty, boys
    have 14% ( 1%) of their remaining standing height to
    grow. This is approximately 22.5 cm ( 1 cm) made up
    of 13 cm in sitting height and 9.5 cm in subischial leg
    length. Girls have 12% ( 1%) of their standing height to
    grow. This is approximately 20.5 cm ( 1 cm) made up
    of 12 cm in sitting height and 8.5 cm in subischial leg
    length (12,3436) (Figs. 2,3).

    Growth rate peaks during puberty between 13 and 15
    years of bone age in boys and 11 and 13 years of bone
    age in girls. By the time girls and boys pass bone ages of
    13 and 15, respectively, lower limb growth comes virtually
    to a standstill, with all remaining growth (4.5 cm)
    taking place in sitting height
    (12,3436).

    I can't post the whole article because it is a PDF file and I can't find a link anymore to the article...who knows where I picked it up. But I think this clearly shows that what I have seen in ballet students, i.e. in the ninth grade some of the ballet students suddenly look longer in the torso relative to their legs.

    I wish I could post the whole file because it's extremely interesting and has a couple of great charts. If you can get hold of it somehow, it is a good find.

  2. #2
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    That is interesting Ballet Mom, thank you for posting!

    I have always been told - by my consultant, who was one of the top spinal surgeons in the UK - that by the age of 10 (when I had my first fusion), the torso has reached 80% of its potential adult height, and most further growth would be in the legs. Perhaps this is what they believed a few years back!

    I guess the main thing to note is that having a fusion from T1-T12 at the age of ten did not cause me any problems or make me look abnormally short. I still have quite large post-op S curve (45/35 degrees) which has also made my torso shorter than it should be, but it's not noticeable to anyone but myself (I notice because often the straps on tops and dresses are too long! ). I personally don't think there should be any worries about fusing kids of 12 or 13, unless those kids need to reach a certain height in order to follow a specific career, though of course it's always nice to have a little extra height.

    One bonus is that whilst people don't notice a short torso, they DO notice that you seem to have long legs instead, which is a very very cool

  3. #3
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    Quote Originally Posted by tonibunny View Post
    That is interesting Ballet Mom, thank you for posting!

    One bonus is that whilst people don't notice a short torso, they DO notice that you seem to have long legs instead, which is a very very cool
    I agree Tonibunny, the relatively longer legs is a feature, not a bug!

  4. #4
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    Quote Originally Posted by tonibunny View Post
    That is interesting Ballet Mom, thank you for posting!

    I have always been told - by my consultant, who was one of the top spinal surgeons in the UK - that by the age of 10 (when I had my first fusion), the torso has reached 80% of its potential adult height, and most further growth would be in the legs. Perhaps this is what they believed a few years back!
    That is close to what I have heard. I have also heard that there is no set pattern which sounds more reasonable. Apparently orthopedic surgeons disagree. I'm guessing we can find articles supporting all these positions.

    I might do a literature survey to see if there is "equipoise" or not.
    Sharon, mother of identical twin girls with scoliosis

    No island of sanity.

    Question: What do you call alternative medicine that works?
    Answer: Medicine


    "We are all African."

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