Authors: Joseph C Risser
Publish Date: 2009/09/18
Volume: 468, Issue: 3, Pages: 646-653
Abstract
This Classic article is a reprint of the original work by Joseph C Risser The Iliac Apophysis An Invaluable Sign in the Management of Scoliosis An accompanying biographical sketch of Joseph C Risser MD is available at DOI 101007/s1199900910950 The Classic Article is ©1958 by Lippincott Williams Wilkins and is reprinted with permission from Risser JC The iliac apophysis an invaluable sign in the management of scoliosis Clin Orthop Relat Res 195811111–119Growth and completion of growth of the body is best shown by development of the bone growth centers epiphyses and apophyses The ossification of the carpal bones have long been used to indicate the bone age of a child In infancy the time of femoral head ossification is also used to determine age A delay in development usually is associated with a delay in metabolismThe last ossification centers to appear and develop are the iliac crest apophysis and finally the apophysis of the ischial tuberosity The latter is smaller more difficult to visualize in roentgenogram and thus is of little significance whereas the iliac apophysis is plainly visible and has a rather long time element in its developmentCoincident with the development of the excursion of ossification of the iliac apophysis across the iliac crest the vertebral growth plates are completed and spinal growth is finished It is difficult to visualize the vertebral body growth plates and determine growth completion Because of an almost simultaneous development of the iliac apophysis and the vertebral growth plates vertebral growth completion can be determined by observation of the development of the iliac apophysisShows the posterior capping of the iliac apophysis See arrows over the pelvis This boy also had a congenital anomaly at 13 He was an untreated case followed over a period of 10 years during which period his curve Increased over 20° until completion of the iliac apophysis
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