Journal List > J Korean Bone Joint Tumor Soc > v.17(1) > 1051983

Jung, Jeong, and Park: Growth Expectation in Children: Leg Length Discrepancy Related with Bone Tumor in Children

Abstract

The main goals of treatment of malignant bone tumor are the prolongation of life survival and the improvement of quality of life. In growing children, however, leg length discrepancy (LLD) is one of major problem in the treatment of malignant bone tumors. Therefore, the precise understanding of growth in children is essential, and the prediction of LLD is critical in deciding the time and options of surgery. In addition, to use the adequate method of growth expectation, periodic followup and collaboration with patient's parents are needed.

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Figure 1.
This graph showing pubertal growth in girls.
jkbjts-17-1f1.tif
Figure 2.
This graph showing pubertal growth in boys.
jkbjts-17-1f2.tif
Figure 3.
This showing the Sauvegrain method of assessing skeletal age.
jkbjts-17-1f3.tif
Figure 4.
This showing the stages of closure of the olecrenon in relation to the pubertal growth and the Risser sign.
jkbjts-17-1f4.tif
Figure 5.
These radiographs showing each stage of Risser Sign.
jkbjts-17-1f5.tif
Figure 6.
This showing contributions of the various growth plates to the length of the lower limb and its individual bones.
jkbjts-17-1f6.tif
Figure 7.
This showing an average total length of the femur and tibia with a 1 and 2 standard deviation range in girls based on chronologic age provided by Green and Anderson.
jkbjts-17-1f7.tif
Figure 8.
Plain radiograph showing osteosarcoma on right proximal femur and reconstruction with tumor prosthesis of 7.6 years old patient.
jkbjts-17-1f8.tif
Figure 9.
This showing the progression of leg length discrepancy in same patient.
jkbjts-17-1f9.tif
Figure 10.
This drawing showing the Moseley straight-line graph.
jkbjts-17-1f10.tif
Figure 11.
Plain radiographs showing osteosarcoma on left distal femur, reconstruction with allograft, and about 7 cm LLD after 4 years follow up.
jkbjts-17-1f11.tif
Table 1.
Characteristics of Growth Pattern
Period Characteristics
Intrauterine period First 6 months: rapid length increase, reach 70% of expected birth length
Next 3 months: rapid weight gain
Birth-5 years Most rapid growth rate, especially first year of life: double the birth height, 62% of the final height
Sitting height and leg length increase at the same rate
5 years-onset of puberty Marked deceleration in growth: standing height increase at approximately 5.5 cm/year
Leg length account for 2/3 of total gain in height
Puberty Acceleration of growth velocity
Increase of standing height: 20.5 cm (girls), 22.5 cm (boys)
Sitting height account for 2/3 of total gain in height
Table 2.
Length of Femur and Tibia
Femur Tibia
At birth 9 cm 7 cm
At growth maturation Girls 47 cm 37 cm
Boys 44 cm 34 cm
Table 3.
Lower-limb Multipliers
Age Multiplier Age Multiplier
(yrs+mos) Boys Girls (yrs+mos) Boys Girls
Birth 5.080 4.630 7+6 1.520 1.370
0+3 4.550 4.155 8+0 1.470 1.330
0+6 4.050 3.725 8+6 1.420 1.290
0+9 3.600 3.300 9+0 1.380 1.260
1+0 3.240 2.970 9+6 1.340 1.220
1+3 2.975 2.750 10+0 1.310 1.190
1+6 2.825 2.600 10+6 1.280 1.160
1+9 2.700 2.490 11+0 1.240 1.130
2+0 2.590 2.390 11+6 1.220 1.100
2+3 2.480 2.295 12+0 1.180 1.070
2+6 2.385 2.200 12+6 1.160 1.050
2+9 2.300 2.125 13+0 1.130 1.030
3+0 2.230 2.050 13+6 1.100 1.010
3+6 2.110 1.925 14+0 1.080 1.000
4+0 2.000 1.830 14+6 1.060
4+6 1.890 1.740 15+0 1.040
5+0 1.820 1.660 15+6 1.020
5+6 1.740 1.580 16+0 1.010
6+0 1.670 1.510 16+6 1.010
6+6 1.620 1.460 17+0 1.000
7+0 1.570 1.430

yrs, years;

mos, months.

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