University Of Tasmania

File(s) not publicly available

Skeletal age deviation assessed by the Tanner-Whitehouse 2 method is associated with bone mass and fracture risk in children

journal contribution
posted on 2023-05-16, 17:16 authored by Graeme JonesGraeme Jones, Ma, D
The aim of this population-based case-control study was to describe the association among skeletal age deviation (SAD), bone density, and upper limb fracture risk in male and female children aged 9-16 years. A total of 321 fracture cases and 321 randomly selected individually matched controls were studied. Skeletal age was assessed by standard atlas. Bone mineral density (BMD) was measured by dual-energy X-ray absorptiometry (DXA) and metacarpal index (MI). There were no significant differences in mean skeletal age or chronological age between fracture cases and controls. However, SAD was associated with total, hand, and female fracture risk (all P < 0.05). The fracture associations became nonsignificant after adjustment for BMD and MI in all subgroups with the exception of hand fractures (OR, 0.67/year; 95% CI, 0.47-0.96). SAD was also positively associated with BMD at all sites (r = 0.33-0.35, all P < 0.05) and MI (r = 0.20, P < 0.05). The strength of association reduced but remained significant at most sites after adjustment for body size, maturity, age, and sex. In conclusion, SAD is positively associated with measures of bone strength and negatively associated with upper limb fracture risk (especially those of the hand) in children. SAD is simple to measure and gives additional information regarding bone health and fracture risk in children. © 2004 Elsevier Inc. All rights reserved.


Publication title









Menzies Institute for Medical Research


Elsevier Science Inc

Place of publication

New York, USA

Repository Status

  • Restricted

Socio-economic Objectives

Clinical health not elsewhere classified

Usage metrics

    University Of Tasmania