Template:Flecker1932 table58

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Chronological Order of Appearance and Fusion of Epiphyses
Before birth:
Both sexes    Appearance     Head of humerus, distal femur, proximal tibia, calcaneum, talus
Female   Appearance   Cuboid
During first year:
Both sexes   Appearance   Hamate, capitate, head of femur, third cuneiform
Female   Appearance   Capitulum, distal radius, distal tibia, distal fibula
Male   Appearance   Cuboid
During second year:
Both sexes   Appearance   Proximal phalanges of inner four fingers
Female   Appearance   First metacarpal, distal phalanges of thumb, middle and ring fingers,

tarsal navicular, first and second cuneiforms

Male   Appearance   Capitulum, distal epiphysis of radius, distal fibula
At age of 2:
Both sexes   Appearance   Innerfourmetacarpals,firstmetatarsal,proximalphalangesoftoes, distal phalanx of hallux
Female   Appearance   Proximal phalanx of thumb, middle row of phalanges of fingers
Male   Appearance   First metacarpal, distal phalanx of thumb, and distal phalanx of

index,firstcuneiform

At age of 3:
Female   Appearance   Patella, proximal fibula, second metatarsal, third metatarsal, middle phalangesof second, third and fourth toes, distal phalanges of third and fourth toes
Male   Appearance   Triquetrum, proximal phalanx of thumb, middle phalanges of middle and ring fingers, tarsal navicular, second cuneiform
At age of 4:
Both sexes   Appearance   Fourth metatarsal
Female   Appearance

Fusion

Head of radius, fifth metatarsal

Greater tubercle to head of humerus

Male   Appearance   Lunate, middle phalanges of index and litle fingers, distal phalanges

of middle and ring fingers, second metatarsal, third metatarsal, middle phalanx of second toe

At age of 5:
Both sexes   Appearance   Navicular (carpal), multangulum majus, greater trochanter, distal

phalanx of second toe

Female   Appearance   Medial epicondyle, distal ulna, lunate, triquetrum, multangulum

minus, distal phalanx of index

Male   Appearance
Head of radius, distal phalanx of litle finger, patella, proximal

fibula, fifth metatarsal, middle phalanges of third and fourth toes, distal phalanges of third and fourth toes

Fusion Greater tubercle to head of humerus
At age of 6:
Male   Appearance   Medial epicondyle, distal ulna, multangulum minus
At age of 7:
Female   Appearance   Distal phalanx of litle finger
Fusion Rami ofischium and pubis
At age of 8:
Both sexes   Appearance   Apophysis of calcaneus
Female   Appearance   Olecranon
At age of 9:
At age of 10:
At age of 11:
At age of 12:
At age of 13:
At age of 14:
Female   Appearance   Acromion, iliac crest, lesser trochanter
Fusion   Olecranon, upper radius, proximal phalanx of ring finger, distal phalanx of thumb, head of femur, greater trochanter, distal tibia and fibula, apophysis calcaneus, first metatarsal, proximal phalanges oftoes
Male   Appearance   Proximal sesamoid of thumb, base of fifth metatarsal
At age of 15:
Both sexes   Appearance   Sesamoid of little finger
Fusion   Distal phalanges of second, third and fourth toes
Female   Appearance   Sesamoid of index and little fingers
Fusion   Medial epicondyle, first metacarpal, proximal phalanx of thumb, distal phalanges of inner four fingers, proximal tibia, outer four metatarsals, middle phalanx of second toe, distal phalanges of innerfourtoes
Male   Appearance   Acromion
Fusion   Ilium, ischium and pubis
At age of 16:
Female   Appearance   Distal sesamoid of thumb, tuber ischii
Fusion   Inner four metacarpals, proximal phalanges of index, middle and litle fingers, middle phalanges of fingers
Male   Fusion   Lower conjoint epiphysis of humerus, medial epicondyle, olecranon, head of radius, distal phalanx of middle finger, apophysis of calcaneus
At age of 17:
Both sexes   Fusion   Acromion
Female   Fusion   Upper conjoint epiphysis of humerus, distal ulna, distal femur, proximal fibula
Male   Appearance   Distalsesamoidofthumb
Fusion   First metacarpal, proximal phalanges of thumb and ring finger, middle phalanges, index, middle and ring fingers, distal phalanges of thumb, index, ring and little fingers, head of femur, greater trochanter,distal tibia and fibula, metatarsals, proximal phalanges of toes, middle phalanx of second toe, distal phalanx of hallux
At age of 18:
Female   Fusion   Distal radius
Male   Fusion   Inner four metacarpals, proximal phalanges of index, middle and litle fingers, middle phalanges of litle finger, proximal tibia
At age of 19:
Male   Appearance   Sesamoid of index, tuber ischii
Fusion   upper conjoint epiphysis of humerus, distal radius and ulna, distal femur, proximal fibula
At age of 20:
Both sexes   Fusion   Iliac crest
Male   Fusion   Tuber ischii
At age of 21:
Both sexes   Appearance   Clavicle
Female   Fusion   Tuber ischii
At age of 22:
Both sexes   Fusion   Clavicle


|- | Both sexes   | Appearance   |- | Female   | Appearance   |- | Male   | Appearance  


Female ” At the age of 9: Female Appearance Male Fusion At the age of 10: Male Appearance At the age of 11: Female Appearance

Male ”»

FUSION OF EPIPHYSES

Head of humerus, distal femur, proximal tibia, calcaneum, talus Cuboid

Hamate, capitate, head of femur, third cuneiform Capitulum, distal radius, distal tibia, distal fibula Cuboid

Proximal phalanges of inner four fingers

First metacarpal, distal phalanges of thumb, middle and ring fingers, tarsal navicular, first and second cuneiforms

Capitulum, distal epiphysis of radius, distal fibula

Inner four metacarpals, first metatarsal, proximal phalanges of toes, distal phalanx of hallux

Proximal phalanx of thumb, middle row of phalanges of fingers

First metacarpal, distal phalanx of thumb, and distal phalanx of index, first cuneiform

Patella, proximal fibula, second metatarsal, third metatarsal, middle phalanges of second, third and fourth toes, distal phalanges of third and fourth toes

Triquetrum, proximal phalanx of thumb, middle phalanges of middle and ring fingers, tarsal navicular, second cuneiform

Fourth metatarsal

Head of radius, fifth metatarsal

Greater tubercle to head of humerus

Lunate, middle phalanges of index and little fingers, distal phalanges of middle and ring fingers, second metatarsal, third metatarsal, middle phalanx of second toe

Navicular (carpal), multangulum majus, greater trochanter, distal phalanx of second toe Medial epicondyle, distal ulna, lunate, triquetrum, multangulum minus, distal phalanx of index

Head of radius, distal phalanx of little finger, patella, proximal fibula, fifth metatarsal, middle phalanges of third and fourth toes, distal phalanges of third and fourth toes

Greater tubercle to head of humerus

Medial epicondyle, distal ulna, multangulum minus

Distal phalanx of little finger Rami of ischium and pubis

Apophysis of calcaneus Olecranon

Trochlea, pisiform Rami of ischium and pubis

Trochlea, olecranon

Lateral epicondyle Pisiform Times of Appearance and Fusion of Epiphyses 159

At the age of 12:

Male Appearance At the age of 13: Female Appearance Fusion Male ” At the age of 14: Female Appearance Fusion Male Appearance

At the age of 15: Both sexes Appearance

Fusion Female Appearance Fusion Male Appearance Fusion At the age of 16: Female Appearance Fusion Male ”

At the age of 17:

Both sexes Fusion

Female ”

Male Appearance Fusion

At the age of 18:

Female Fusion Male ” At the age of 19: Male Appearance Fusion At the age of 20: Both sexes Fusion Male ”

At the age of 21: Both sexes Appearance Female Fusion

At the age of 22: Both sexes Fusion

Lateral epicondyle

Proximal sesamoid of thumb

Lower conjoint epiphysis of humerus, distal phalanx of thumb, bodies ilium, ischium and pubis

Capitulum to trochlea and lateral epicondyle

Acromion, iliac crest, lesser trochanter

Olecranon, upper radius, proximal phalanx of ring finger, distal phalanx of thumb, head of femur, greater trochanter, distal tibia and fibula, apophysis calcaneus, first metatarsal, proximal phalanges of toes

Proximal sesamoid of thumb, base of fifth metatarsal

Sesamoid of little finger

_Distal phalanges of second, third and fourth toes

Sesamoid of index and little fingers

Medial epicondyle, first metacarpal, proximal phalanx of thumb, distal phalanges of inner four fingers, proximal tibia, outer four metatarsals, middle phalanx of second toe, distal phalanges of inner four toes :

Acromion

Ilium, ischium and pubis

Distal sesamoid of thumb, tuber ischii

Inner four metacarpals, proximal phalanges of index, middle and little fingers, middle phalanges of fingers

Lower conjoint epiphysis of humerus, medial epicondyle, olecranon, head of radius, distal phalanx of middle finger, apophysis of calcaneus

Acromion

Upper conjoint epiphysis of humerus, distal ulna, distal femur, proximal fibula

Distal sesamoid of thumb

First metacarpal, proximal phalanges of thumb and ring finger, middle phalanges, index, middle and ring fingers, distal phalanges of thumb, index, ring and little fingers, head of femur, greater trochanter, distal tibia and fibula, metatarsals, proximal phalanges of toes, middle phalanx of second toe, distal phalanx of hallux

Distal radius Inner four metacarpals, proximal phalanges of index, middle and little fingers, middle phalanges of little finger, proximal tibia

Sesamoid of index, tuber ischii Upper conjoint epiphysis of humerus, distal radius and ulna, distal femur, proximal fibula

Tliac crest Tuber ischii