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Assessing the skeletal maturity of the hand-wrist Fels method. By Alex F. Roche Wm. Cameron Chumlea and David Thissen. Springfield IL Charles C. Thomas. 1988. viii + 339 pp. figures tables appendix index. $57

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260
BOOK REVIEWS
influencing the public, are good indications
of the chasm that separates these two
worlds. The ever present “dialectical tension” between popular racialism and the desire of some scholars to negate the bases
upon which racialist claims are grounded
may be better seen in this historical perspective.
In dealing less with bones (other than
those of the skull) and more with scholarly
ideas of the relationships between bodies
(“races”) and behavior, these chapters provide insights into the rich intellectual history of anthropology- In the final essay in
this collection, subtitled “Shenvood Washburn and the New Physical Anthropology,
1950-1980,” Donna Haraway documents the
shift that led to the modern thrust in physical anthropology. Haraway’s contribution
also provides considerable uplift after the
depressing data so clearly related in the two
preceeding articles. Haraway’s deft recounting of these years enables us to see clearly
the important recent trends in our discipline. The changes in physical anthropology
noted here give us hope for our own future,
both as scholars and as human beings. Although hers is not intended to summarize
ASSESSINGTHE SKELETAL
MATURITY
OF THE
HAND-WRIST:
FELS METHOD.
By Alex F.
Roche, Wm. Cameron Chumlea, and
David Thissen. Springfield, IL: Charles C.
Thomas. 1988. viii + 339 pp., figures, tables, appendix, index. $57.50 (cloth).
the other papers, Haraway caps this collection by providing an idea of just how far we
came during those three decades.
What is clear in many of these essays is the
ethnocentrism of the early monogenists who,
believing in the unity of Homo sapiens, saw
the potential for all humans to make the
cultural transformations needed to perfect
their “human nature’’ (that is, to become just
like their observers). The polygenists, believing in biocultural dissimilarities, more
closely resemble the cultural relativists of
the present in their “understanding” of cultural stability. Fortunately, Haraway’s essay reminds us that the more subtle problem
of sexism had hardly been recognized. This is
a volume that clearly belongs in every university library. Others like it would be welcome additions to this series.
MARSHALL
JOSEPH
BECKER
Department of Anthropology
West Chester University
West Chester, Pennsylvania
LITERATURE CITED
Morgan LH (1868)The AmericanBeaver and His Works.
Philadelphia: J.B. Lippincott.
are certainly more representative of modal
US.maturational patterns than those from
either the Greulich-Pyle or TW2 (Tanner et
al., 1983) systems. The FELS method is
based on the independent assessment of 98
maturity indicators, including both graded
morphological changes and metric relationships (e.g., ratios of epiphyseal to metaphyA new text that (according to the dust seal width). These traits are coded and anajacket description) “presents an easy- lyzed by means of IBM-PC-compatible
to-learn and quick-to-apply method for as- software, using a maximum likelihood apsessing skeletal maturity of the hand-wrist” proach.
should be a welcome addition to the personal
Herein lies a difficulty for the reviewers.
and institutional libraries of those whose Because its application requires the softresearch, clinical, and/or teaching interests ware, which is not sold with the book, we
include the growth and development of the could not actually apply the technique. The
human skeleton. The authors advance a development of a standardized statistical
truly new method of skeletal maturity as- program is reasonable and will ultimately
sessment derived after more than a decade of minimize error and confusion among reresearch on nearly 700 midwestern US.sub- searchers. However, purchasers should be
jects from the FELS longitudinal growth aware that prior to applying the FELS
study. The FELS assessment method has method they also will need to acquire (purbeen designed to produce estimates of skele- chase price not specified) the FELShw distal maturity (and age) that are more objec- kette; and they probably will wish to invest
tive than those from the Greulich-Pyle atlas in the set of 30 training radiographs as well.
method (Greulich and Pyle, 1959) and that
Overall, the book is excellently written
261
BOOK REVIEWS
and illustrated. Chapter I, “Maturity and Its
Assessment,” thoroughly, but concisely, reviews the relevant literature on the development of methods for skeletal age assessment
in humans. Chapter 11, “Assessing the Maturity of the Hand-Wrist,” provides a critical
review of the procedures, methods, and observations that historically have been incorporated in previous systems of assessment.
Although they are clearly laying the foundation for the introduction of their new system
in these chapters, the authors are to be
commended for a most even-handed coverage of the work of others. These two chapters
alone would make this book a worthwhile
addition to the reading lists of upper-level
undergraduate or graduate students as well
as a review for clinicians, researchers, and
university lecturers interested in the topic.
In the next three chapters, the reader is
introduced to information essential to understanding and applying the FELS method.
In addition to describing the sample from
which the system was derived and the procedures for obtaining hand-wrist radiographs,
Chapter 111, “Materials and Methods,’’ amply details the five criteria (i.e., discrimination, universality, reliability, validity, and
completeness) and the nine-step protocol
employed to identify the specific set of 98
bone maturity indicators that ultimately
characterize the system. Statistical and
practical reasons for decisions regarding selection of these maturity indicators are outlined in a straightforward manner, allowing
the reader a genuine appreciation for the
complexity and thoroughness of the protocol.
Although the next two chapters on the
actual application of the FELS method display comparable clarity of text, this does not
compensate for some genuine problems contained there. In Chapter IV, “Hand-Wrist
Maturity Indicators,” there are few typographical errors and the line drawings of
carpal juxtaposition and development are
especially helpful. However, the reader
would have benefited by a layout that consistently featured textual and photographic descriptions of an indicator on opposite pages
(they are often back-to-back). Additional arrows on the photographs would also have
helped: differentiating capping and fusion of
the medial third vs. the central and lateral
thirds of the epiphyseodiaphyseal junction of
the radius, for example. The photographs are
generally well chosen, although we have
looked hard and cannot see the adductor
sesamoid in the photographs said to illus-
trate its ossification (Fig. 63). Chapter V,
“Procedures for Applying the FELS Method,”
provides detailed suggestions for improving
the accuracy and replicability of the assessor. However, the section that explains the
interpretation of FELS method skeletal maturity assessments is marred by editorial
errors: e.g., incorrect identification of two
tables essential to interpretation and an example of how to calculate the normal range of
skeletal ages in which the tables cited do not
yield the correct numbers. Additionally, Tables XX and XXI, which list indicators to be
assessed at specific ages in males and females, respectively, are truncated at age 8
years. If not an editorial error, the reason for
this is not readily deduced from the text.
Similarly, the data recording form (Appendix B) does not include the age ranges for
the indicators as stated (p. 59). These are
minor errors, but they may generate a fair
amount of confusion for the reader.
In spite of these difficulties, this book
almost certainly should be added to the bookshelves of researchers and clinicians already
familiar with assessment and interpretation
of skeletal maturity. With minor revisions,
or the inclusion of an accurate errata list, it
would also be extremely useful in the teaching of advanced undergraduates and graduate students. The underlying assumptions
and methodology used to establish the FELS
method appear to be excellent. It would
surely be good if this method were to replace
the Greulich-Pyle atlas in common clinical
use. It seems that improving upon “unrecorded impressions [being] combined subjectively to obtain hand-wrist skeletal ages” (p.
27) was the authors’ fundamental objective.
Achievement of this goal will be dependent
on clinicians’ willingness to procure the diskette and train themselves in this accessible
but not easy system. We await further developments with interest.
SUSAN
PFEIFFER
MICHAEL
C. MAHANEY
School of Human Biology
University of Guelph
Guelph, Ontario, Canada
LITERATURE CITED
Greulich WW, and Pyle SI (1959) Radiographic Atlas of
Skeletal Development of the Hand and Wrist. Stanford, C A Stanford University Press.
Whitehouse RH, CamersonN, Marshall WA,
TannerJM,
Healy MJR, and Goldstein H (1983) Assessment of
Skeletal Maturity and Prediction of Adult Height
(TW2 Method).London: Academic Press.
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thissen, chumlea, figuren, fels, 339, 1988, method, alex, charles, cameron, index, viii, wrist, skeletal, roche, springfield, hands, maturity, appendixes, thomas, tablet, assessing, david
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