PURPOSE Distal radius and ulna (DRU) classification scheme has been proposed for predicting skeletal maturity in patients with idiopathic scoliosis (IS). However, the utilization of DRU classification scheme in the assessment of growth peak and curve progression in IS was still inconclusive. This study aimed to correlate the distal radius and ulna stages with several indicators for growth potential and to evaluate the predictive value of DRU system for curve progression in braced female IS patients. METHODS This was a consecutive longitudinal study including physically immature IS girls receiving standardized bracing treatment and regularly followed up every 3-6 months until brace weaning. The following data of each visit were collected: chronologic age, standing height, Cobb angle, spinal length, Risser sign, digital skeletal age (DSA) scores and DRU scores. The height velocity (HV), spinal growth velocity (SGV) and angle velocity (AV) of each visit were calculated. The correlation among radius stage, ulna stage, Risser sign, height, spinal length, HV, SGV and AV was studied. RESULTS Forty braced IS girls with 349 longitudinal whole spine X-rays were reviewed. The average DRU scores at initial visit were R6.5 ± 1.1 and U4.5 ± 1.2 for radius and ulna, respectively. Both the radius stages between R5 and R8 and ulna stages between U3 and U6 indicated high SGV and high HV. The DSA scores were 402.1 ± 48.8 and 430.8 ± 44.4 at R7 and R8, respectively. The AV values were - 5.9 ± 12.4°/y and - 0.4 ± 1.5°/y at R5 and R6, which increased to 5.9 ± 17.3°/y, 3.1 ± 15.7°/y and 4.2 ± 12.2°/y at R7, R8 and R9, respectively. The DSA scores were 387.3 ± 65.7 for U5 and 432.9 ± 48.5 for U6, respectively. The AV values were - 3.1 ± 0.3°/y at U3, - 1.7 ± 9.3°/y at U4, 2.3 ± 16.1°/y at U5, 5.4 ± 15.5°/y at U6 and 4.4 ± 12.9°/y at U7. CONCLUSIONS Both distal radius and ulna scores correlate with the longitudinal growth potential, and thus, the DRU scoring scheme is an alternative predictor for growth potential and curve progression in girls with IS. These slides can be retrieved under Electronic Supplementary Material.

中文翻译：

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利用远端radius骨和尺骨分类方案预测接受支撑治疗的特发性脊柱侧弯女孩的生长峰值和曲线进展。

目的已提出了远端radius骨和尺骨（DRU）分类方案，用于预测特发性脊柱侧凸（IS）患者的骨骼成熟度。然而，DRU分类方案在IS的生长峰和曲线进展评估中的利用仍是不确定的。这项研究旨在将aimed骨远端和尺骨分期与多种潜在生长指标相关联，并评估DRU系统对女性IS患者弯道进展的预测价值。方法这是一项连续的纵向研究，其中包括身体不成熟的IS女孩接受标准化的支撑治疗，并每3-6个月定期随访直至支撑断奶。每次访问均收集以下数据：年代，身高，科布角，脊柱长度，Risser征，数字骨骼年龄（DSA）分数和DRU分数。计算每次访视的身高速度（HV），脊柱生长速度（SGV）和角速度（AV）。研究radius骨，尺骨，Risser征，身高，脊柱长度，HV，SGV和AV之间的相关性。结果回顾了40具IS支撑的349例纵向全脊柱X射线摄影女孩。初诊时radius骨和尺骨的平均DRU评分分别为R6.5±1.1和U4.5±1.2。R5和R8之间的半径阶段以及U3和U6之间的尺骨阶段均表示高SGV和高HV。R7和R8的DSA分数分别为402.1±48.8和430.8±44.4。在R5和R6处，AV值分别为-5.9±12.4°/ y和-0.4±1.5°/ y，在R7处分别增加至5.9±17.3°/ y，3.1±15.7°/ y和4.2±12.2°/ y， R8和R9分别。DSA分数为387.3±65。U5分别为7和U6分别为432.9±48.5。AV值在U3为-3.1±0.3°/ y，在U4为-1.7±9.3°/ y，在U5为2.3±16.1°/ y，在U6为5.4±15.5°/ y，在U7为4.4±12.9°/ y 。结论远端radius骨和尺骨评分均与纵向生长潜力相关，因此，DRU评分方案是IS患儿生长潜力和曲线进展的替代性预测因子。这些幻灯片可以在电子补充材料下找到。