File talk:Keibel Mall Table-Skeleton 5.jpg
From Embryology
| Table Of Ossification Of The Bones Of The Superior Extremity | |||
|---|---|---|---|
| (Days and weeks refer to the prenatal, years to the postnatal period.) | |||
| Bone | Centres | Time of appearance of centre | Union of primary and secondary centres; remarks. |
| Clavicle | Diaphysis | 6th week | There are two centres in the shaft, a medial and a lateral. These blend on the 45th day (Mall). Shaft and epiphysis unite between the 20th and 25th years. |
| Sternal epiphysis | 18th to 20th year | ||
| Scapula | Primary centres: | The chief centre appears near the lateral angle. The subcoracoid centre appears at the base of the coracoid process and also gives rise to a part of the superior margin of the glenoid fossa. The coracoid process joins the body about the age of puberty. The acromial epiphysis centres (two or three in number) fuse with one another soon after their appearance and with the spine between the 22nd and 25th years (Quain); 20th year (Wilms). The subcoracoid and the epiphysis of the coracoid process, the glenoid fossa, the inferior angle, and the vertebral margin join between the 18th and 24th years in the order mentioned (Sappey). | |
| 1. That of the body, the spine, and the base of the glenoid cavity. | 8th week (Mall) (see footer) | ||
| 2. Goraooid process | 1st year | ||
| 3. Subcoracoid | 10th to 12th year | ||
| Epiphyses: | |||
| Acromial epiphyses | 15th to 18th year | ||
| Epiphysis of the inferior angle. | 16 to 18th year | ||
| Epiphyses of the vertebral border. | 18th to 20th year | ||
| Epiphyses of upper surface of coracoid. | 16th to 18th year. | ||
| Epiphysis of surface of glenoid fossa. | 16th to 18th year. | ||
| Humerus | Diaphysis | 6th to 7th week (Mall) | The epiphyses of the head, the tuberculum majus and the tuberculum minus (the last is inconstant) unite with one another in 4th-6th year and with the shaft in 20th-25th year. The epiphyses of the capitulum, lateral epicondyle, and trochlea unite with one another and then in the 16th-17th year join the shaft. The epiphysis of the medial epicondyle joins the shaft in the 18th year. |
| Epiphyses: | |||
| Head | 1st to 2d year | ||
| Tuberculum majus | 2d to 3d year | ||
| Tuberculum minus | 3d to 5th year | ||
| Capitulum | 2d to 3d year | ||
| Epioondylus med | 5th to 8th year | ||
| Lateral margin of trochlea | 11th to 12th year | ||
| Epicondylus lat | 12th to 14th year | ||
| Radius | Diaphysis | 7th week (Mall) | The superior epiphysis and shaft unite between the 17th and 20th years. The inferior epiphysis and shaft about the 21st year (Pryor); M 21st year, F 21st-25th year (Sappey). Sometimes an epiphysis is found m the tuberosity (R. and K.) and in the styloid process (Sappey). |
| Epiphyses: | |||
| Carpal end | F 8th month - M 15th month (Pryor) | ||
| Humeral end | 6th-7th year | ||
| Ulna | Diaphysis | 7th week | The centre for the shaft of the ulna arises a few days later than that for the radius. The proximal epiphysis is united to the shaft about the 17th year; the inferior epiphysis between the 18th and 20th years; F 20th - 21st years, M 21st - 24th years (Sappey). There is sometimes an epiphysis in the styloid process (Sohwegel) and in the tip of the olecranon process (Sappey). |
| Epiphyses: | |||
| Carpal end | F 6th-7th year - M 7th-8th year (Pryor) | ||
| Humeral end | 10th year | ||
| Carpus | Os capitatum | F 3d-6th month M 4th-10th month | The navicular sometimes has two centres of ossification (Serres. Rambaud and Renault). Serres and Pryor have described two centres of ossification in the lunatum. Debierre has described two centres in the pisiform, one in a girl of eleven, the other in a boy of twelve. The OS hamatum may have a special centre for the hamular process. Pryor has found two centres in the triquetrum. Pryor (1908), describes the centres of ossification of the carpal bones as assuming shapes characteristic of each bone at an early period. |
| Os hamatum | F 5th-10th month M 6th-12th month | ||
| Os triquetrum | F 2d-3d year M about 3 years | ||
| Os lunatum | F 3rd-4th year M about 4 years | ||
| Os naviculare | F at 4 years, or early in 5th year M about 5 years | ||
| Os mult. maj. | F 4th-5th year M 5th-6th year | ||
| Osmult. min. | F 4th-5th year M 6th-6th year | ||
| Os pisiforme | F 9th-10th year M 12th-3th year | ||
| Metacarpals | Diaphyses | 9th week (Mall) | The centres for the shafts of the second and third metacarpals are the first to appear. There may be a distal epiphysis for the first metacarpal and a proximal epiphysis for the second. Pryor (1906). found the distal epiphysis of the first metacarpal in about 6 per cent, of cases. It is a family characteristic. It arises before the 4th year and unites later. Pryor found the proximal epiphysis of the second metacarpal in six out of two hundred families. It unites with the shaft between the 4th and 6th-7th year; sometimes, however, not until the 14th year. In the seal and some other animals all the metacarpals have proximal and distal epiphyses (Quain). The epiphyses join the shafts between the 15th and 20th years. There may bean independent epiphysis for the styloid process of the 5th metacarpal. The epiphysis of the metacarpal of the index finger appears first. This is followed by those of the 3d, 4th, 5th, and 1st digits. |
| Proximal epiphysis of the first metacarpal | 3d year | ||
| Distal epiphyses of the metacarpals | 2d year | ||
| Phalanges | Diaphyses | 9th week (Mall) | |
| First row | Proximal epiphyses | 1st-3rd year (Pryor) | The shafts of the phalanges of the second and third fingers are the first to show centres of ossification. The phalanges of the little finger are the last, the epiphysis in the middle finger is the first to appear. This is followed by those of the 4th, 2d, 5th, and 1st digits. |
| Middle row | Diaphyses | 11th-12th week (Mall) | The centres in the shafts of this row are the last to appear. The epiphysis of the phalanx of the middle finger is the first to appear. This is followed by those of the ring, index, and little finger (Pryor). |
| Proximal epiphyses | 2nd-3rd year | ||
| Terminal row | Diaphyses | 7th-8th week | The terminal phalanx of the thumb is the first to show a centre of ossification in the shaft. This is the first centre of ossification in the hand. It is developed in connective tissue while the centres of the other phalanges are developed in cartilage (Mall). The epiphysis of the ungual phalanx of the thumb is followed by those of the middle, ring, index, and little fingers. The fusion of the epiphyses of the phalanges with the diaphyses takes place in the 18th-20th year. |
| Proximal epiphyses | 2nd-3rd year | ||
| Sesamoid bones | Ossification begins generally in the 13th - 14th years, and may not take place until after middle life (Thilenius). For table of relative frequency in the embryo and adult see p. 385. | ||
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