BACKGROUND The calculation of remaining growth in children and the timing of epiphysiodesis in those with leg-length discrepancy (LLD) is most often done with 4 methods: the Green-Anderson, White-Menelaus, Moseley straight-line graph, and multiplier methods. The aims of this study were to identify the most accurate method with use of bone age or chronological age and to evaluate the influence of including inhibition in the calculations. METHODS One hundred and ninety-one children (10 to 17 years of age) with LLD who underwent surgical closure of the growth plate and were followed until skeletal maturity were identified from a local health register. Patients had at least 2 leg-length examinations with simultaneous bone-age assessments (according to the Greulich and Pyle method), with the last examination performed ≤6 months before surgery. The accuracy of each method was calculated as the mean absolute prediction error (predicted leg length - actual leg length at maturity) for the short leg, the long leg, and the LLD. Comparisons were made among the 4 methods and among calculations made with chronological age versus bone age and those made with versus those without incorporation of a reduced growth rate (inhibition) of the short leg compared with the long leg. RESULTS The White-Menelaus method with use of bone age and a fixed inhibition rate was the most accurate method, with a prediction error of 1.5 ± 1.5 cm for the short leg, 1.0 ± 1.2 cm for the long leg, and 0.7 ± 0.7 cm for the LLD. Pairwise comparison of short-leg length and LLD according to the White-Menelaus and other methods showed that they were significantly different (p ≤ 0.002). The calculated inhibition rate did not increase accuracy. CONCLUSIONS The White-Menelaus method used with bone age and constant inhibition should be the preferred method when predicting remaining growth and the timing of epiphysiodesis in children between 10 and 17 years of age. One examination is in most cases sufficient for the preoperative clinical investigation when chronological age and bone age are concordant. LEVEL OF EVIDENCE Prognostic Level III . See Instructions for Authors for a complete description of levels of evidence.

中文翻译：

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4 种不同方法估计骨骺固定的剩余生长和时间的准确性。


背景 儿童剩余生长的计算和腿长差异 （LLD） 儿童的骨骺固定术的时间通常使用 4 种方法完成：Green-Anderson、White-Menelaus、Moseley 直线图和乘数法。本研究的目的是确定使用骨龄或实际年龄的最准确方法，并评估在计算中包括抑制的影响。方法 从当地健康登记处确定了 191 例接受手术闭合生长板并随访直至骨骼成熟的 LLD 儿童 （10 至 17 岁）。患者至少进行了 2 次腿长检查，同时进行了骨龄评估 （根据 Greulich 和 Pyle 方法），最后一次检查在手术前 ≤6 个月进行。每种方法的准确性计算为短腿、长腿和 LLD 的平均绝对预测误差（预测腿长 - 成熟时的实际腿长）。对 4 种方法进行了比较，并在实际年龄与骨龄的计算之间进行了比较，以及与没有结合短腿与长腿相比生长速率降低（抑制）的方法。结果 使用骨龄和固定抑制率的 White-Menelaus 方法是最准确的方法， 短腿预测误差为 1.5 ± 1.5 cm，长腿预测误差为 1.0 ± 1.2 cm，LLD 预测误差为 0.7 ± 0.7 cm。根据 White-Menelaus 和其他方法对短腿长度和 LLD 进行成对比较，结果显示它们存在显著差异 （p ≤ 0.002）。计算的抑制率并没有提高准确性。 结论 在预测 10 至 17 岁儿童的剩余生长和骨骺固定时间时，使用骨龄和持续抑制的 White-Menelaus 方法应该是首选方法。当实际年龄和骨龄一致时，在大多数情况下，一次检查足以进行术前临床检查。证据级别 预后 III 级 .有关证据级别的完整描述，请参阅作者说明。