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Purpose To compare the computerized Greulich-Pyle based bone age with elbow bone age. Materials and Methods A total of 2126 patients (1525 girls; 601 boys) whose elbow bone age was within the evaluable range by the Sauvegrain method, and who simultaneously underwent hand radiography, were enrolled in the study. The 1st-bone age and VUNO score of the hand were evaluated using VUNOMed-BoneAge software. The correlation between the hand and elbow bone age was analyzed according to the child’s gender and the probability of 1st-bone age. Results The correlation between VUNO score and elbow bone age (r = 0.898) was higher than the correlation between 1st-bone age and elbow bone age (r = 0.879). Moreover, the VUNO score showed a better correlation with the elbow bone age in patients with a 1st-bone age probability of less than 70%, or in girls. Elbow bone age was more advanced compared to hand bone age, and this difference increased until the middle of puberty and gradually decreased in the latter half. Conclusion The computerized Greulich-Pyle based hand bone age showed a significant correlation with the elbow bone age at puberty. However, since the elbow bone age tends to advance faster than the hand bone age, caution is required while judging the bone age during puberty.

The checkrein deformity describes tethering of the flexor hallucis longus tendon, which mainly occurs after fracture of the distal tibia. The deformity increases with dorsiflexion of the ankle and decreases or disappears with plantarflexion of the ankle. In some cases, the deformity may occasionally include the second and third toes. In the current study, the authors experienced secondary checkrein deformity of all lesser toes after open reduction and plate fixation for comminuted fracture of the calcaneus. As a treatment, plate and screws were removed, followed by an additional medial incision which showed a partially ruptured flexor digitorum longus tendon with severe adhesion. Resection of the adhesed tendon and tenodesis of its distal portion to the flexor hallucis longus was performed for correction of the checkrein deformity. Then the lessor toe checkrein deformity recovered immediately. The authors report on this rare lessor toe checkrein deformity after calcaneal fracture fixation with a review of literature. [ABSTRACT FROM AUTHOR]