Skeletal Development of Cleft Palate Children as Determined by Hand-Wrist Roentgenographs: A Preliminary Study

Abstract

Studies by Mainland (4—6), Pryor ('7), and Todd (8) have shown the value of the hand—wrist roentgenograph as a diagnostic and developmental study aid in determining skeletal growth. According to Greulich and Pyle (8), the hand-wrist roentgenograph is the most useful single procedure available at present for determining the developmental status of the child. They point out that, by such procedure, accelerated or delayed sexual maturity may be detected or imbalances in skeletal maturation as a result of an endocrine dysfunction can be demonstrated. Additional review of the literature failed to disclose information on skeletal development directly related to the cleft palate child. This prompted consideration of a study designed to determine the skeletal, dental, and chronological ages of cleft palate children and to compare them with accepted standards for children without clefts (3). It was felt that this preliminary study of individuals with cleft palates might indi— cate whether these subjects display skeletal development within the normal range expected for children Without clefts, or whether the group of cleft palate children tend to exhibit an altered pattern of general skeletal growth. The purpose of the study, then, was to determine whether, for children with clefts, a significant deviation from normal skeletal development as evidenced by hand-wrist roentgenographs could be demonstrated. Method Forty—eight subjects, each presenting some form of palatal cleft with or without an associated cleft lip, were selected at random from a group of white cleft palate children. To assist in determining chronological, dental, and skeletal ages for each child, certain diagnostic data and study aids were obtained. These included sex, height, weight, type of cleft, oral examination, complete intraoral roentgenographs, and hand-wrist roent-genographs.