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Longitudinal growth rate of the distal tibia and fibula in children.

In 61 children (30 boys and 31 girls), the growth rates in the distal tibia and fibula were recorded by use of a roentgen stereophotogrammetric technique. The average observation time was about one year and seven months. The growth rates were correlated with chronologic and skeletal age. Adjusting for skeletal age did not significantly change the average growth rates or the scattering of the values. The mean growth rate and the remaining growth from about nine years of age in the boys and eight years of age in the girls were calculated for separate age groups. In the distal tibia in the boys and the girls, the average growth rate decreases from a plateau of about 11 and ten years of age, respectively. Decreasing growth rates were found somewhat later in the distal tibia than in the distal fibula in both the boys and the girls. The growth rates were close to zero at about the same time in the distal tibia and fibula in both sexes. In determining the remaining growth, the large biologic variability indicates the importance of serial measurements on the individual patient. The individual growth charts, together with clinical and radiographic estimation of maturity, provide a guideline for treatment of a patient with growth disturbance of the distal tibia and fibula.