Age- and sex-specific morphometric parameters of the phalanges in preschool children

Abstract

Radiographic examination of the skeletal system provides extremely valuable evidence to study the evolution of the child’s body, to assess its age-related morphological differentiation, and allows detection of developmental defects. 

Aim - to determine the age- and sex-specific morphometric parameters of the phalanges of the right and left hands in children aged 4-7 years to identify the developmental patterns of their topography at this age.

Materials and methods. The study of morphometric parameters of the phalanges of the fingers of the right and left hands was based on a retrospective examination of 179 radiograms of children of both sexes (83 boys and 96 girls) aged 4-7 years. The research was conducted under standard conditions based on the Department of Pediatric Traumatology of Chernivtsi Emergency Hospital according to the agreement on cooperation.

Results. The study revealed heterochronous growth of the phalanges in children aged 4-7 years. In the first digit of the right hand, the distal phalanx grows actively at 4-5 years, and the proximal phalanx at 6-7 years; in the left hand, both phalanges show peak growth at 5-6 years. In the second digit, the proximal phalanges of both hands elongate intensively at 6-7 years, the middle phalanges at 4-5 years, while the distal phalanges grow uniformly throughout the period.

For the third and fourth digits of the right hand, accelerated growth of the middle and distal phalanges is characteristic at 4-5 years, and the proximal ones during the 5-7 year period. On the left hand, the growth of all phalanges in these digits is synchronized and occurs mainly at 5-6 years. In the fifth digit, the middle phalanges of both hands grow actively at 5-6 years. The proximal and distal phalanges of the little finger demonstrate complex bilateral and sex-specific differentiation: in boys, growth peaks are shifted toward 5-7 years, while in girls, intensive growth is recorded earlier, between 4 and 6 years.

Conclusions. Accelerated growth of the hand bones in preschoolers most frequently occurs at 6 years of age, with the most pronounced dynamics observed in the phalanges of the third digit. A distinct age-related bilateral asymmetry in phalangeal length was established, reflecting individual and sex-specific patterns in the topographical development of the hand skeleton during this age period.

The study was conducted according to the principles of the Declaration of Helsinki. The Local Ethics Committee of Chernivtsi Emergency Hospital approved the protocol of the study. Informed consent was obtained from the parents of children in order to conduct the study.

The author declares no conflict of interest.