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Group Title: Bulletin / University of Florida. Agricultural Experiment Station ;, no. 588
Title: A Study of wrist development of school children by sex, age and race
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Full Citation
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Permanent Link: http://ufdc.ufl.edu/UF00027206/00001
 Material Information
Title: A Study of wrist development of school children by sex, age and race
Series Title: Bulletin / University of Florida. Agricultural Experiment Station ;, no. 588
Physical Description: 18 p. : ill. ; 23 cm.
Language: English
Creator: Abbott, O. D. (Ouida Davis), b 1892
Publisher: University of Florida Agricultural Experiment Station,
Publication Date: 1957.
 Subjects
Subject: Wrist -- Growth.
Children -- Nutrition. -- Florida
School children -- Food -- Florida.
 Notes
General Note: Cover title.
General Note: Includes bibliographical references (p 18).
Funding: Bulletin (University of Florida. Agricultural Experiment Station) ;
 Record Information
Bibliographic ID: UF00027206
Volume ID: VID00001
Source Institution: University of Florida
Rights Management: All rights reserved by the source institution and holding location.
Resource Identifier: aleph - 000926800
notis - AEN7500
oclc - 18283296

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Full Text


Bulletin 588


UNIVERSITY OF FLORIDA
AGRICULTURAL EXPERIMENT STATIONS
J. R. BECKENBACH, Director
GAINESVILLE, FLORIDA







A Study of

Wrist Development of School Children

By Sex, Age and Race


O. D. ABBOTT,


R. O. TOWNSEND,
AND V. CHEW


R. B. FRENCH


TECHNICAL BULLETIN








Single copies free to Florida residents upon request to
AGRICULTURAL EXPERIMENT STATION
GAINESVILLE, FLORIDA


July 1957








A Study of
Wrist Development of School Children

By Sex, Age and Race

O. D. ABBOTT, R. O. TOWNSEND, R. B. FRENCH
AND V. CHEW 1

A study of carpal and epiphyseal development of children in
a small rural school in one of the poorer sections of the state was
begun by Abbott et al in 1940 (1).2 Roentgenograms of the wrists
showed that both sequence and time of appearance of the carpals
had been interrupted in approximately half the children. Per-
centages of immature and missing carpals were much higher in
boys than in girls in the same age groups. From this study it
was concluded that retardation of ossification was closely related
to the low consumption of milk.
Since the results of this early study were reported, many
socio-economic changes have occurred that should have contribu-
ted to improvement in child life. The emphasis on preventive
medicine, public health programs and higher economic status of
many families in both rural and urban areas are representative
of these changes. The role of nutrition in relation to abundant
health is now receiving the attention of all concerned with child
health and welfare. These advances should have resulted in im-
proved nutrition of all children and be reflected in their skeletal
structure. It has, therefore, seemed desirable to study a group
of average population children for the impact of these changes
on carpal development.
The present investigation was undertaken to compare carpal
and epiphyseal development of white and Negro children as to
age and as to sex, and to survey some of the environmental fac-
tors which may have affected skeletal development as shown by
the carpals.
MATERIALS AND METHODS
Location of Schools and Selection of Subjects.-The four co-
operating schools (3 white and 1 Negro) were located in the gen-
eral farming section in the north-central part of the state. These
SDr. Abbott, home economist; Mrs. Townsend, assistant in nutrition;
Dr. French, biochemist, Agricultural Experiment Station; Mr. Chew, for-
merly assistant professor of agronomy (statistics), College of Agriculture.
2 Italics in parentheses refer to Literature Cited.






Florida Agricultural Experiment Stations


were large grammar schools which served both rural and urban
areas. The subjects were unselected and consisted of 782 white
and 179 Negro children and represented an average school popu-
lation of children of ages 6 to 12 years.
Roentgenographic Techniques. All roentgenograms were
made of the right hand on nonscreen high speed films in card-
board holders with General Electric portable X-ray equipment.
The study was primarily cross-sectional, but when retardation or
unusual abnormality was observed, successive films were made.
Treatment of Data.-(a) Measurements of Carpal Develop-
ment.-Todd's Atlas (7) presents representative roentgenograms
of the right hand of boys and girls for successive age periods.
Accompanying these standards are descriptive guides of changes
most typical of each carpal and of the epiphyses of the ulna and
radius for each age group and for each sex. By comparing the
roentgenograms of these children with Todd's standards, the
carpals and epiphyses were classified for sex and age as mature,
immature and missing. The assignment was made on the basis
of angulations and contours of each of these parts.
(b) Statistical Analysis.-Percentages of mature carpals for
each age-sex-race combination were transformed into arcsines,
since the count data had a range of percentage from 6 to 100.
These weighted averages were then transformed back to per-
centages to give the approximate average percentages of children
with mature wrist bones which were classified according to race,
according to sex and according to age.
The significance of these differences was evaluated by an
analysis of variance. A complete analysis was made of the age
groups 7-8, 8-9, and 9-10 years. Because of the small number
of Negro children in the age group 6-7, only a partial analysis was
made. Data on the age-group 10-12 years were not analyzed.

RESULTS
Data presented in Tables 1-4 show variations in carpal and
epiphyseal development and in skeletal mineralization of 782
white and 179 Negro school children in the age group 6 to 12
years.
I. Bone Maturity
Ages 6-7 and 7-10 years.
The significance of the differences in bone maturity was de-
termined by an analysis of variance as shown in Table 5 and cer-




TABLE 1.-VARIATIONS IN DEVELOPMENT OF CARPAL CENTERS AND DISTAL EPIPHYSES OF RADIUS AND ULNA OF 369
WHITES GIRLS.


Number of Subjects .................. ... 94
Age in Years ............-................... .. 6-7


Carpals
Capitate
Mature...-- .. .- ..........
Im m ature ...........................-.....
Hamate
Mature ..- ... ..... ...- .....
Immature ........... .........
Triquetrum
M ature ........ .......
Immature .......................
Lunate
M ature ...- ..................
Immature ..........................
Missing .......----...---...............-------
Navicular
M ature ..................................
Im m ature ......... ..................... ...
M missing ....... ............. ...........
Multangulum majus
Mature ..........................
Immature ..--...........................
M missing ..................................
Multangulum minus
M ature ............ -... ----........
Immature .-...............................
M missing ..................... ................
Pisiform
Present -......-.......................
Distal radius
M ature ...... ............. ..........
Immature ..........................-----
Distal ulna
M nature ................. --.... .......
Im m ature ..................................
Missing ......................----......-- ..-
Mineralization
Good ..................... ......-
Light ......................... .... .... .. ..
Poor ................ --........ ....... -
Scorings on radial shaft ....... ...I


I 88
S7-8


% No.

47 51
53 37

47 51
53 37

45 48
55 40

43 46
57 42

38 43
49 44
13 1

38 43
55 41
7 4

39 45
53 43
8 1


No.

55
30

55
30

52
33

51
34

46
38
1

46
38
1

47
37
1

16

56
29

46
35
4

40
40
5
19


9-10
No. %

44 75
15 25

43 73
16 27

40 68
19 32

41 69
17 29
1 2

40 68
18 30
1 2

40 68
18 30
1 2

40 68
19 32


10-11
No. %

19 73
7 27

19 73
7 27

19 73
7 27

19 73
7 27

19 73
7 27

19 73
7 27

19 73
7 27

14 54

24 92
2 8

22 85
4 15

18 69
7 27
1 4
2 8


11-12
No. %

15 88
2 12

15 88
2 12

15 88
2 12

15 88
2 12

15 88 M
15 88
2 12



15 88
2 12
15 88 0
2 12



15 88


- I __ __ I I


_ -


_ .






TABLE 2.-VARIATIONS IN DEVELOPMENT OF CARPAL CENTERS AND DISTAL EPIPHYSES OF RADIUS AND ULNA OF 413
WHITE BOYS.


Number of Subjects ----......------- -- 96 91
Age in Years --...----...-.......---. ....... 6-7 7-8
Carpals No. % No.
Capitate
Mature ..--..-- ---.------ 33 34 30
Immature ....-......---..--.------ 63 66 61
Hamate
Mature --.------------ 31 32 29
Immature ...--..-----.......------- 65 68 62
Triquetrum
Mature --------------------- 35 36 25
Immature ..--...--...............---- 59 62 66
Missing ...--..---. .......---- ------- 2 02
Lunate
Mature ---...-. ---..-------. 25 26 24
Immature .......--..........-----.---. 59 61 65
Missing -...-.........-----.-------.. 12 13 2
Navicular
Mature .--..--......----- ...----- 14 15 14
Immature ......-...............--.-------. 37 38 58
Missing ......................---- ---------- 45 47 19
Multangulum majus
Mature .-------.. ----.....-------- 14 15 16
Immature .......-..... .....-- .......---- 33 34 50
Missing -..---...-.....------ ----. 49 51 25
Multangulum minus
Mature -...-..-..-- ----.. ----- 16 16 17
Immature .--........--...........------.. 38 40 46
Missing ...........-----...............--------...... 42 44 28
Distal radius
Mature ......--.-.......-- ......-------... 41 43 46
Immature .....-- ..-........ -----... 55 57 45
Distal Ulna
Mature .....-- ------------- --------- 19 20 14
Immature ..-...-...................------ 34
Missing ....--...--..--..--.... -.. ----- 77 80 43
Pisiform
Present -.....----......-..--..-......-.......-------- 0 0
Mineralization
Good ..- .....................----------.... 26 27 20
Light ---...-......-..--..-- ...--..--- -- 57 59 48
Poor .--.--- ----.--------- 13 14 23
Scorings on radius .............-......-.. 33 34 31


26
71
03

15
64
21

18
55
27

19
50
31

51
49

16
37
47


22
53
25
34


42
55
2
36
54
9
35
50
14

34
56
9
59
40
34
40
25

1
33
46
20
32


36
58
06
36
58
06
44
45
11

60
40
36
44
20

09

22
64
14
18


1
13
21
2

12
23
1

12
23
1

20
16

13
22
1
5

7
23
6
7


03 1
36 19
58 17
06
33 19
64 16
03 1

33 20
64 15
03 1

56 23
44 13

36 20
61 15
03 1
14 11

19 8
64 23
17 5
19 4


99 55
8-9 9-10
% No. % No.
33 43 43 29
67 56 57 26
32 43 43 28
68 56 57 27
27 42 42 25
73 57 58 30


36 36
10-11 11-12
% No. % No. %

53 17 47 24 67
47 19 53 12 33
51 17 47 24 67
49 19 53 12 33
45 15 42 20 56
55 21 58 16 44

44 14 39 20 55
56 21 58 15 42


,





TABLE 3.-VARIATIONS IN DEVELOPMENT OF CARPAL CENTERS AND DISTAL EPIPHYSES OF RADIUS AND ULNA OF 74
NEGRO GIRLS.


Number of Subjects ........- .... .. i.. 7
Age in Years ........................ .......-- 6-7
Carpals No. % |
Capitate
Mature ............. ................- 6 86
Immature .......---... .....----... 1 14
Hamate
Mature ................- ........... 6 86
Immature ............ ............... ... 1 14
Triquetrum
Mature ..................-- .....---. 5 71
Im m ature ................................ 2 29
Lunate
M ature ...................... ...... ..- . 4 57
Im mature ........................-.......... 3 43
Navicular
Mature ................................- 3 43
Immature .............................- 4 57
Multangulum majus I
Mature ............-................ 3 43
Immature ............................. 3 43
Missing ..................-.. .... --- 1 14
Multangulum minus
Mature ....................... .......--.. 3 43
Immature ...........-..........--... I 4 57
Pisiform
Present ................... ---.............
Distal radius
Mature ............. ...... ....-... 7 100
Distal ulna I
Mature ..............- ..... ...... 3 43
Im m ature .............................
Missing ...-.................... .......... i 4 57
Mineralization
Good ........................- --.... ..-- ----
Light .......... .. ....... ..---- I 5 71
Poor -.... --...... ....- -... --- 2 29
Scoring on distal radius ........--... 3 43


No.

21
7
21
7

19
9

25
3

21
7
24
3
1
21
7

4

28

18
6
4


75
25

75
25

68
32

89
11

75
25

86
11
3


13 5 2
9-10 10-11 11-12
% No. % No. % No.

79 10 77 2 40 1
21 3 23 3 60 1
79 10 77 2 40 1
21 3 23 3 60 1
79 10 77 2 40 1
21 3 23 3 60 1 i

74 10 77 2 40 1
26 3 23 3 60 1 1
74 10 77 2 40 1
26 3 23 3 60 1
68 10 77 2 40 1
32 3 23 3 60 1


75 13 68
25 6 32

14 5 26
L00 19 100

65 17 90
21 1 5
14 1, 5

68 12 63
32 7 37
29 8 42


2 40
3 60


5 100

5 100

1 20
2 40
2 40
1 20


1 50
1 50

2 100

2 100

2 100



2 100


T


1





TABLE 4.-VARIATIONS IN DEVELOPMENT OF CARPAL CENTERS AND DISTAL EPIPHYSES OF RADIUS AND ULNA OF 105
NEGRO BOYS.


Number of Subjects -........................
Age in Years .-....-.... ...- .............-....
Carpals
Capitate
Mature ................... ....----
Immature -.........-......-.......
Hamate
M ature ...... .......... ..............
Immature .....................-........
Triquetrum
Mature .......-- ............
Immature ............................
Missing .......................--......--....
Lunate
Mature .......... ----
Im m ature .....-.-.............- .........
M missing ................ -............
Navicular
Mature .......................-- ........
Immature .-.........................--
Missing ....................---
Multangulum majus
Mature ................-........
Immature .......................-----
M missing .. ................ ....... .. -
Multangulum minus
Mature -......... ...........-----
Immature .............--.........
Missing .-...-.............----
Pisiform
Present .....................................
Distal radius
M ature ..................... -----
Immature _......- ...................--.
Distal ulna
Mature .. .....-- ...
Immature ...................-----
M missing .......................... ....
Mineralization
Good .................----- ---..----
Light .--.........-...-. ................
Poor ........ ............ ---..
Scorings on radius -.......... ....


15
6-7
No. % No.
8 53 28
77 6

8 53 28
7 47 6

8 53 18
7 47 14
2

6 40 20
5 33 7
4 27 7

4 27 7
5 33 16
6 40 11

5 33 8
4 27 16
6 40 10

2 13 8
4 27 16
9 60 10

1

12 80 34
3 20
2 13 7
4
13 87 23
-- 2
8 53 26
7 47 6
6 40 7


^


82
18

82
18

53
41
6

58
21
21

21
47
32

24
47
29

24
47
29

3

100

21
12
67

6
76
18
21


I


24
8-9
No. %

18 75
6 25

18 75
6 25

17 71
7 29

15 63
9 38

8 33
16 67

10 42
13 54
1 4

10 42
13 54
1 4

1 4

24 100

11 46
4 16
9 38

1 4
15 63
8 33
4 16


5 45
6 55


9 82
2 18


16
9-10
No. %

11 69
5 31

11 69
5 31

6 37
10 63

8 50
8 50

1 6
15 94


11 1
10-11
o. %

6 55
5 45

7 64
4 36

6 55
5 45

6 55
5 45

5 45
6 55

6 55
5 45


5
11-12
No. %

2 40
3 60

2 40
3 60

2 40
3 60

2 40
3 60

3 60
2 40

2 40
3 60

2 40
3 60
Co



5 100

2 40
3 60


3 60
2 40


16 100

8 50
7 44
1 6

1 6
9 57
6 37
3 19


5 45
6 55


------







Wrist Development of School Children


tain relationships expressed as average percentages in Table 6.
In the age groups 6-7 and 7-10 the races differed significantly in
maturity of wrist bones in favor of the Negro children, and so
did the sexes in favor of the girls. It is shown also that the
difference between races was not dependent on sex.
The children in the several age groups also differed in bone
maturity (Table 6). However, average maturity did not increase
significantly from age group 8-9 to age group 9-10.
The effects of age and race in age group 7-10 was highly sig-
nificant (Table 5). The effects of age and sex were not signifi-
cant. The differences in bone maturity (Table 5) among the
ossific centers differed significantly and depended on race and on
sex but not on age.


TABLE 5.-ANALYSIS OF VARIANCE OF DATA ON BONE
AGE GROUPS 6-7 AND 7-10 YEARS.


Sources of Variation D. F.


Races R 1
Sexes S 1
RXS 1
Ages A -
AXR -
AX S
Bones B 8
BXR 8
BXS 8
BXA -


6-7
Variance
Ratio


9.71*
84.42***
2.36 n. s.






19.85***
5.36*
1 n. s.


D. F.


1
1
1
2
2
2
8
8
8
16


MATURITY FROM


7-10
Variance
Ratio

12.52**
33.15***
1 n. s.
8.03***
8.43***
2.54 n. s.
26.34***
8.91***
4:78***
1. n.s.


n. s. not significant.
statistically significant at the 5% level.
** statistically significant at the 1% level.
*** statistically significant at the 0.1% level.

II.-Mineralization

An analysis of data given in Tables 7 and 8 shows that there
is a significant difference between races in degree of mineraliza-
tion in favor of the white children. The percentages of white
girls with the highest scoring were larger than those of the







Florida Agricultural Experiment Stations


TABLE 6.-NUMBER AND APPROXIMATE AVERAGE PERCENTAGES OF CHILDREN
WITI MATURE WRIST BONES, CLASSIFIED ACCORDING TO RACE, SEX AND
AGE GROUPS.


Age-Groups


6-7

7-8
8-9
9-10

Totals............


Male

No. %
29 30

23 25
41 41
25 45

118 34


Vhite
Female

No. %
40 42

50 57
50 59
42 71

182 56


Negro
Male Female

No. % No. %
6 39 4 55

17 51 23 81
15 64 15 81
9 53 11 81

47 53 53 71


TABLE 7.-ANALYSIS OF VARIANCE OF DATA ON MINERALIZATION FROM
AGE GROUPS 7-10 YEARS.

Mineralization

Source of Variation D. F. Variance Ratio


Races ...... -............... ......... 1 69.35*
Sexes ........ ......... ......... 1 1 n. s.
R X S ............ .......... ... 1 18.37*
Ages ............................... . .2 I 1.13 n. s.
A X R ....................... ....... 2 2.31 n. s.
A X R X ........................ 2

Total ........................ ........ 11

Statistically significant at the 5% level.

TABLE 8.-DEGREE OF MINERALIZATION OF WRIST BONES OF CHILDREN IN
THE AGE-GROUP 7-10 YEARS CLASSIFIED ACCORDING TO RACE, TO SEX,
AND TO AGE AS A PERCENTAGE OF MAXIMUM SCORE OF MINERALIZATION.

Age-Groups White Negro
Male Female Male Female


7-8
8-9
9-10


No.
44
56 5
30 5


%o No. %
18 63 72
i7 60 71
54 44 74


No. % No. %
15 44 10 34
8 35 6 32
6 35 2 12






Wrist Development of School Children


white boys, while Negro boys had a higher scoring than Negro
girls. It is shown also that age groups did not differ significantly
in degree of mineralization.
Table 9 gives the data for analysis of mineralization of the
age group 6-7, together with results of tests for significance of
race and sex differences and their interaction. Because of the
small number of Negro children in this group, actual counts are
given.
Chi-square tests show that racial difference was highly signifi-
cant but sex was not. Effect of race was independent of sex.

III.-Missing Centers
In the statistical analysis, missing centers for carpals and
distal ulna were considered as an aspect of immaturity, but be-
cause of their importance as "health determinators," special men-
tion is justified. From the data presented in Tables 1-4, it is evi-
dent that the percentages of missing centers were much less in
girls than in boys, and in Negro girls than in the white. In the
two groups of boys the percentages were about the same. How-
ever, as age increased, all centers except that of the distal ulna
were present in Negro boys in the age-group 10-11 years, whereas
three carpal centers and the distal ulna were still missing in one
white boy in the age-group 11-12. It is shown also that the distal
ulna is present in all Negro girls in the age-group 9-10 but is a
year later in the white girls.
IV.-Radial Scorings
Scorings which take the form of transverse lines on the radial
shaft continuous with the distal epiphyses are due to interrup-
tions of growth caused by severe illnesses or other adverse influ-
ences. It will be noted in Tables 1-4 that the percentages of
scoring in the different age groups are somewhat higher in
Negro girls than in white ones, and are higher in both white and
Negro boys than in the girls of both races.

V.-Roentgenograms of Selected Children
Two years following the initial roentgenograms, a second one
was made of 25 white and 23 Negro children. Selections were
made on the basis of gross carpal retardation in relation to chron-
ological age. The roentgenograms showed that 42 percent of the
white and 48 percent of the Negro children had gained from
6 to 36 months in carpal development, while the remainder showed
no change or a further lag of 6 months.















TABLE 9.-DEGREE OF MINERALIZATION OF CHILDREN AGED 6-7 (ACTUAL COUNTS).


CM CF

0 0

8 5

7 2


15 7


Race

WM + WF CM

63

103

22


190


WM-white, male
WF-white, female
CM-colored, male
CF-colored, female


+ CF

0

13

9


22


Sex

WM + CM

26

65

20


111


WF +


2
18.93*** X = 5.3 n.s.
2
(5.99 required
for significance
at 5% level)


CF

37

53

11


101


2
X =
2


Interaction

WM + CF WF + CM

26 37

62 56

15 16


2.09 n.s.


Good ..-..

Light ...

Poor .....


Total ..--..


13 9


96 94







Wrist Development of School Children


Roentgenograms of 1 girl and 5 boys ages 6-9 years showing
initial carpal development and changes in 2 years are presented
here. Retarded carpal development due to gross malnutrition
and other health disturbances is shown in the left illustration
for each child. The effect of correction or the lack of it is shown
in the right illustration.


,






*.i "1 *
:" k.".


i rLI


Subject 1. The hand of a grossly mal-
nourished girl is shown (left) with carpal
retardation of 2 years, 8 months. The later
film (right) shows the effect of an improved
diet on carpal development which is now ap-
proximately the same as the standard for
chronological age.



Subject 2. The hand of a very poorly
nourished boy (left) with carpal retarda-
tion of 4 years, 3 months. No change was
made in his diet which consisted primarily
of foods high in carbohydrates and fats. As
shown (at right), there was an increase in
growth of hand but no change in degree of
carpal retardation.


Subject 3. The hand of a boy with car-
pal retardation of 3 years, 6 months is
shown (at left). Diseased tonsils with fre-
quent attacks of tonsillitis had so affected
general health that both growth and carpal
development were retarded. Removal of
the tonsils resulted in improved health and
nutrition as well as in physical and mental
performance. In 2 years there was marked
increase in growth and, as shown at right,
a gain of 3 years, 6 months in carpal de-
velopment.


Subject 4. The hand of a Negro boy 8
yLar- of age (left) with carpal retardation
o:f 5 years, 6 months. Weight at premature
1: ,th was less than 4 pounds. At 5 years
,:f age he was adopted by foster parents
after' gross neglect and abandonment. Bet-
tL i:are and treatment had brought about
a -radual improvement in general health
I.it when first examined, his nutritional
-att-is was poor. The later film (right)
Sh.:, :. a carpal gain of 5 years in the 2-year
interval.


EM ANB V








A& ~i

Ww 4 -







Florida Agriculturcal Experiment Stations


Iii




6--


S.0iject 5. The hand of a Negro boy
it i cth, pal retardation of approximately 1
.van ii shown left, for comparison with his
i1rn-ti :-l i twin given herein as Subject 46,
Bot. ii.rd available the same dietary and
.l.tler teatment. As shown right, the car-
p.;l it-liardation remained at 1 year.


Subject 6. The hand of Subject 5's iden-
tii:.;l ti in is shown (left) with a carpal
rUt'ii.ll1i'.,n of 5 years, 1 month. Dietary
.i11 i i e- % ith frequent upsets and migraine
Ilic.lri.li-, had reduced food intake and made
ic~ -alr:. the omission of essential foods
ftuil the d..iet. There had been a great im-
i, r..'-,.-, inr in the allergic attacks for 1 year
alii tihe: were less frequent. This was at-
rt ilut-.l Iy the mother to his becoming of
suhuul ag'v and association with other chil-
dren. The later film (right) shows a car-
pal retardation of 3 years.


DISCUSSION
Many factors are involved in the process of growth and de-
velopment of children and individual variations appear in ossifi-
cation, as have been noted in other developmental entities as in
eruption of teeth and in height-weight relations. In the appraisal
of the variations in skeletal development, consideration must be
given to those judged hereditary and to those due to environment
and disease. In the present study, advancement or retardation
in carpal development of one year in relation to chronological age
was considered to be within the ii.irmnil pattern of variations,
while greater retardation was coii.idered to be a sign of some
environmental interference in development.
Whether the differences in carpal dvellpmneint between sexes
and those between white and Negro race- are due to heredity or
for the most part to environment is somewhat controversial. It
is often claimed that as growth and development continue, the
female matures faster than the male and that if roentgenograms
are taken of the same bones in both boys and girls of the same
identical age, those of the girl will show advancement. Accord-
ing to Todd (7) "No analysis of r.,entgeingi'aphic features has
ever been produced in support of this claim."
Although both Francis (5) and Todd (7), recognize the ad-
vancement of the female in skeletal development, Todd is of the
opinion that the effect of health upon the several bones at differ-
ent stages of maturation has never been examined, and that the






Wrist Development of School Children


solution to the problem of skeletal maturation of males and fe-
males is to be found in a "longitudinal study of children whose
health history, mental development, social adjustment, family
circumstances, parental inheritance and siblings are all investi-
gated concurrently." While data collected in the present study
show the advancement of the girls over that of the boys in carpal
development, it appears that more data are needed before differ-
ences in skeletal maturation of boys and girls can be attributed
to heredity alone.
It is generally accepted that as a race the American Negro is
subject to a more adverse environment than is the white. How-
ever, in spite of these adverse conditions, this study shows carpal
advancement of the Negro child over that of the white child in
all age-groups. Both Dunham (3) and Christie (2) found skele-
tal advancement of the Negro infant over that of the white was
present at birth and Christie concluded that Negroes were physi-
ologically more mature at birth than the white infant. Yet at
the White House Conference on Child Health and Development
and Protection (8), it was reported that there is no "racial differ-
ences in skeletal development of white and Negro races." This
report, however, was based on the skeletal development of 76
Negro boys and 71 Negro girls.
It might be helpful to consider some environmental factors
which may delay ossification. Among the more important ones
are those of hormonal imbalance, severe illnesses and gross mal-
nutrition.
In the many nutritional studies carried on by members of this
department, relatively few cases of glandular disturbances have
been noted and these were not included in this study. In 1940
Francis (4) found that the orderly progress of ossification may
be modified by illness. Greulich and Pyle (6) also found that
febrile and other illnesses could impair maturation of the bones
of the hand.
In the present study relatively few cases of osseous retarda-
tion could be definitely associated with past illnesses. The out-
standing defects affecting ossification were enlarged and infected
tonsils with frequent attacks of tonsillitis, and allergies which
were manifest by asthmatic bronchitis. Immunization had evi-
dently reduced the incidence and severity of the common com-
municable diseases of childhood, while modern medicine had
lessened secondary infections which heretofore provided the
greatest damage to the child. The reduced food intake associated
with illness must also be considered as a factor.






Florida Agricultural Experiment Stations


In this, as well as in previous studies, the delaying or inhibit-
ing factor was usually malnutrition. In the study of the diets of
white and Negro children some interesting differences were
found. Practically all white children had been artificially fed,
while practically all Negro children had been breast fed, with
the nursing period extending through the "second summer".
The supplementary food of the white infant was processed baby
food; those of the Negro an abundance of pot liquor and greens
from the table. After weaning, both groups ate with the family.
It appeared that few, if any, foods were rejected by Negro chil-
dren. Therefore at an early age, these children were eating a
basic diet with confections and carbonated beverages at a min-
imum.
On the other hand, it appeared that poor food habits of many
white children were formed in early years. Such basic foods as
milk, eggs, greens and many other vegetables were often rejected
or eaten under protest, while bottled drinks and foods high in
carbohydrates made up the needed calories.
Among both rural and urban children an adequate breakfast
was the exception rather than the rule. A type A lunch which
provides at least one-third of the daily food requirements was
served at all schools for white children. However, due to eating
foods high in carbohydrates at recess, poor eating habits and dis-
likes of certain essential foods, food intake was often low (per-
sonal observation).
As the Negro school had no lunchroom facilities, lunch at best
was very poor and consisted mainly of a bottled drink and a
bakery product (observations by authors and teachers).
Because of improved financial status, changes are taking place
in the diets of many Negro families. It has been noted often that
as income increases, luxury foods tend to crowd out the basic
ones. While Negro children had a higher percentage of mature
carpals for sex and age than white children, the degree of min-
eralization was 35 percent for Negro children 7-10 years of age
and 62 percent for white children in the same age range. Al-
though the degree of mineralization of the carpals of white
children was significantly higher than that of the Negro, yet in
the age group 9-10 years, 29 percent of the white girls and 55
percent of the white boys had immature carpals and in a few
cases a carpal was missing.
From these percentages it may be assumed that while the
infant and preschool diets of Negro children were adequate for
ossification, later diets were inadequate for mineralization. It






Wrist Development of School Children


also follows that while the early diets of white children were
inadequate for ossification, later ones were fairly adequate for
mineralization, but not for the laying down of new centers nor
for the maturation of centers already present.
It was noted that sometimes children in apparent good health
had height and weight values below average, but showed an ad-
vance in ossification. Conversely, rapid growing children tended
to lag in ossification unless the diet furnished an abundance of
minerals. If minerals were not adequate for both processes,
growth was maintained and ossification delayed. This observa-
tion is in agreement with that of Francis (5) who found that
"in children otherwise healthy, epiphyseal ossification may be in-
fluenced by the amount of mineral available in the diet".
It is well recognized that in recovery from severe and pro-
longed illnesses a child's weight increases first, height next and
ossification last. Therefore, in order to support these three proc-
esses, the diet must be not only good but optimum in bone-build-
ing materials.
Upon comparison of carpal development of these groups of
children with that of children of the same sex and age reported
earlier (1), the over-all picture shows some improvement. It is,
of course, realized that improvement in population groups, es-
pecially in respect to change in diet pattern, moves slowly. This
study emphasizes the need for continuing the effort to educate
parents on the importance of basic food requirements, to de-
velop good food habits and to provide optimum diets for ossifica-
tion for children recovering from severe illnesses and for those
growing rapidly.
SUMMARY
Roentgenograms were made of the carpals and epiphyses
of the distal ulna and radius of 782 white and 179 Negro school
children of ages 6 to 12 years.
An analysis of variance shows that the races differed signifi-
cantly as regards maturity of the carpals and epiphyses in favor
of the Negro children, and so did the sexes in favor of the girls.
The difference in carpal development between races did not
depend on sex.
The children in the several age-groups differed in bone ma-
turity. However, average percentages of maturity did not in-
crease significantly from age group 8-9 to age group 9-10.
Races but not sexes differed in degree of mineralization in
favor of the white children. The carpals and epiphyses of the







Florida Agricultural Experiment Stations


white girls were more highly mineralized than those of the white
boys, while the reverse was true of Negro children.
Roentgenograms of selected white and Negro children initi-
ally showing gross carpal retardation were repeated two years
later. The effects of dietary improvement and correction of
physical defects upon carpal development were demonstrated.

LITERATURE CITED

1. ABBOTT, O. D., R. O. TOWNSEND, R. B. FRENCH and C. F. AHMANN. Car-
pal and Epiphyseal Development, Another Index of Nutritional
Status of Rural School Children. Amer. J. Dis. Children. 79 : 69-81.
1950.
2. CHRISTIE, A. Prevalence and distribution of ossification centers of new-
born infants. Amer. Jour. Dis. Children. 77: 335-61. 1949.
3. DUNHAM, E. C., R. M. JENSE and A. CHRISTIE. A consideration of race
and sex in relation to growth and development of infants. Jour. Fed.
141 : 156-60. 1939.
4. FRANCIS, CARL C. The appearance of centers of ossification from 6 to
15 years. Amer. Jour. Phys. Anthrol. 27 : 127-38. 1940.
5. Factors influencing centers of ossification dur-
ing early childhood. II. Comparative study of degree of epiphyseal
ossification in infancy under varying conditions of diet and health.
Amer. Jour. Dis. Children. 59 : 1006-12. 1940.
6. GREULICH, WILLIAM WALTER, and S. IDELL PYLE. Radiographic atlas of
skeletal development of the hand and wrist. Stanford University
Press. 1950.
7. TODD, T. WINGATE. Atlas of skeletal maturation. Hand. T. V. Mosby
Co. 1937.
8. White House Conference on Child Health and Protection. Growth and
development of the child. Pt. II. Anatomy and physiology. pp. 50-
55. Century. 1933.




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