Relación entre tres métodos de evaluación de maduración esquelética con la maduración sexual

Con el fin de determinar cual de los metodos con los que se establece la maduracion esqueletica se relaciona mejor con la madurez del paciente y por tanto, es mas practico y aplicable en la clinica, se busco la relacion entre tres diferentes metodos de evaluacion de la maduracion esqueletica mediante el carpograma (Taranger y Hagg, Greulich y Pyle, y Fishman), con la maduracion sexual (Tanner, orquidiometria de Prader). Se estudiaron 33 pacientes, 18 de sexo masculino y 15 de sexo femenino, entre los 8 y los 13 anos de edad; el criterio de inclusion fue el de ninos sanos con un estadio de maduracion sexual de Tanner I. El 100% de la muestra tanto femenina como masculina se ubico en el estadio F del desarrollo esqueletico. La toma de registros se realizo cada seis meses durante tres anos (2000-2002). En la poblacion masculina no se encontraron asociaciones entre la maduracion esqueletica evaluada de acuerdo con los metodos de Greulich y Pyle, y de Fishman con la maduracion sexual; sin embargo si se encontro relacion entre algunos parametros que integran el metodo de Taranger y Hagg y la maduracion sexual (sesamoideo-Tanner general durante la cuarta muestra y falange media del tercer dedo-volumen testicular derecho durante la misma, al igual que falange media con ambos volumenes testiculares durante la quinta muestra). En la poblacion femenina se presentaron asociaciones estadisticamente significativas entre el metodo de Fishman y la maduracion sexual durante la segunda y sexta muestras; tambien, entre la evaluacion segun Greulich y Pyle y la maduracion sexual durante la sexta muestra y entre el metodo de Taranger y Hagg en la segunda, tercera y sexta muestras (sesamoideo-Tanner, falange media-Tanner y sesamoideo-Tanner respectivamente). ABSTRACT. The objective of this study was to determine which of the methods used to establish the skeletal maturation is better related with the maturity of the patient, and for that reason is more practical and applicable to the clinical practice. The relationship between three different methods for evaluating the skeletal maturation through the hand-wrist film (Taranger and Hagg, Greulich and Pyle, and Fishman) and the sexual maturity (Tanner and Prader) was searched. A total of 33 patients were studied: 18 male and 15 female, between 8 and 13 years. Healthy children in Tanner I sexual maturity stage was the research criterion for inclusion. The 100% of both samples (masculine and feminine) were located in the F stage of skeletal development. Data were taken every six months during the course of three years (2000- 2002). In the male population there were no associations between the skeletal maturation evaluated according to Greulich and Pyle´s method, and Fishman´s method with the sexual maturity. On the other hand, an association was found between Taranger and Hagg´s method and the sexual maturity (sesamoid-general Tanner during the fourth sample and the middle phalanx of the third finger- right testicular volume during the same sample, as happened with the middle phalanx with both testicular volumes during de fifth sample). In the female population there were statistically significant associations between Fishman´s method and the sexual maturity during the second and sixth samples; also between Greulich and Pyle´s evaluation and the sexual maturity during the sixth sample. There was also an association between Taranger and Hagg´s method in the second, third and sixth samples (sesamoid-Tanner, middle phalanx-Tanner and sesamoid-Tanner respectively).