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Growth
Menolaus Rule
- 54% of length from femur
- proximal 4 mm/year
- distal- 9mm/yr
- 46% from tibia
- proximal 6mm/yr
- distal – 4mm/yr
Green & Anderson chart
Straight Line Graph of Mosely
- a manipulation of the Green Anderson Data
Data Analysis
Arithmetic Method – Menolaus
- Assume physis grow at 4,9,6,4 mm / year
- Assume that
- girls stop growing at 14
- boys at 16 years
- Inhibition is calculated
- Growth of the long leg
- growth of the short leg/ growth of the long leg
- Essentially gives the amount that the short leg is losing for each cm of growth by the healthy leg
- Future Discrepancy = current discrepancy + (Growth remaining in the leg) (inhibition)
Growth Remaining Method of Green & Andersen
Straight Line Method (Mosely)
- Plot the long(normal) leg on the reference slope
- Plot the short leg below this
- Now plot the skeletal age based on calender or wrist xray
- Draw in more points
- Get a average age curve & draw this out to where it ends for girl or boy respectively
- Drop a perpendicular which will hit the long leg at maturity
- Line of best fit for short leg intersects this perpendicular to give length at maturity
- epiphysiodesis lines show what happens if you change the slope o
- These methods assume a stable inhibition
Inadequate data
- Extrapolate back to the time when both legs were O length
