SKELETAL MATURATION IN ADOLESCENCE - A COMPARISON BETWEEN THE TANNER-WHITEHOUSE-II AND THE FELS METHOD

In this longitudinal study, skeletal ages assessed with the Fels metho d and the Tanner-Whitehouse II method (TW II) were compared for boys ( n = 30) and girls (n = 30) with a mean chronological age between 12 an d 16 years. The subjects, participating in the Amsterdam Growth and He alth Study, were measured annually between 1977 and 1980, which result ed in four radiographs of the left hand and wrist of every individual. For boys, the mean TW II skeletal age was 0.32 years older than the m ean Fels skeletal age (sd 0.50). Tested at the subsequent chronologica l ages, the mean TW II skeletal ages were 0.05-0.47 years older, the d ifferences being statistically significant at the mean ages of 13, 14 and 15 years. For girls, the mean TW II skeletal age was 0.20 years yo unger than the mean Fels skeletal age Jsd 0.69). At the subsequent chr onological ages, the mean TW II skeletal ages were 0.03 to 0.35 year y ounger, the differences being statistically significant at the mean ch ronological ages of 14 and 15 years. As a consequence of the differenc es between the methods, application of the Fels method resulted in cla ssifying a smaller percentage of buys (10%) as rapid maturers, and a h igher percentage (6.7%) of boys as normal maturers in comparison to th e TW II method. For girls a higher percentage of female adolescents we re classified as rapid (16.7%) and slow maturers (13.3%, but a smaller percentage was classified as normal mature (30%). Differences in the skeletal ages can be ascribed to differences in maturation of the refe rence population, but also to fundamental differences in the statistic al methods of the scoring system and the scales of maturity. Conclusio n There is no agreement ill skeletal ages assessed according to the TW If method and the Fels method in adolescence.