Advanced Research Journal of Public Health and Epidemiology, ISSN: 5167-4231   Vol.  4(2),  pp. 038-064, December, 2019.© Advanced Scholars Journals

Full length Research paper

Growth of the limbs and their segments during childhood and adolescence: a photogrammetric study

N. Louis Attallah^1*, Dalia Louis²

^*1 Alexandria University Medical Schools, Department of Anatomy Alexandria, Egypt (Retired)

² Department of pediatrics Glaa Military Hospital, Heliopolis Cairo, Egypt.

Corresponding author E-mail:[email protected]

Accepted 29 October, 2019

Abstract

A clear picture of patterns of growth for the limbs and their segments is not abundant and difficult to obtain from the literature due to different techniques used, this have confused an overall realistic composite picture for these important parameters. This study used cross-sectional and longitudinal data to establish   normal variation for growth of the limbs during childhood and adolescence in both sexes, and to locate the adolescent growth spurt by calculating velocities of growth cm/year , its timing, intensity, and its relationship to that for  height and sitting height. The extent to which the length of upper and lower limbs may vary in relation to each other, and to the trunk irrespective of age was presented (Bivariate analysis). All limb segments share in the adolescent growth spurt with some variations in its timing and intensity, lower limb is the first to peak, then stature and upper limb, sitting height is the latest, a difference of 1.2 years in boys and 0.9 years in girls. Upper limbs stop growing 0.25 years after lower limbs. There was no significant differences in timing of peak velocity between proximal and distal segments within the same limb. Girls stop growing in their lower limbs earlier than boys by two years, but they continue to grow in their trunk length, so that adult women have larger trunks than men for a given  height . 65% of subjects have their right upper limbs longer, variability and magnitude of limb asymmetry is greater in children with low and high birth weight. Our data provided a clear realistic composite picture for growth of the limbs than the schematic illustrations found in the literature. Results are useful in clinical pediatrics, bivariate standards can be used in conjunction with univariate standards by age to define the exact nature of any abnormality and help in the differential diagnosis of  growth disorders where body proportions are disturbed e.g. achondrplasia , growth hormone deficiency.  Data can be used to improve garment industry and in ergonomics , also in sports to help coaches  to select children for training in specific athletic skills which suits best their trunk / limb proportions, certain body proportions are optimal for certain athletic skills, however favorable training may be.

Key words:  Growth of limbs at adolescence