Orthopedic surgeons commonly use the Risser sign to estimate skeletal
maturity; however, the data presented in the orthopedic literature sup
porting the accuracy of the Risser sign in estimating skeletal maturit
y do not stand up to critical statistical analysis. The Risser sign is
less accurate than chronologic age as a predictor of skeletal age and
should not be used as a substitute for a hand and wrist radiograph in
most cases. The Risser sign is also no better a predictor of scoliosi
s progression than is chronologic age.