Vatech GREEN SMART, User Manual

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15. Appendices
174 Green Smart User Manual
15.4 Hand-wrist Image Evaluation References
Radiographic Evaluation of Skeletal Maturation. A clinically oriented
method based on hand-wrist films.
Fishman LS. 1982

The system of Skeletal Maturation Assessment (SMA)
The System uses only four stages of bone maturation, all found at six anatomical sites
located on the thumb, third finger, fifth finger, and radius, as seen Fig.1. Eleven discrete
adolescent skeletal maturational indicators (SMI’s), covering the entire period of
adolescent development, are found on these six sites (Fig.1 orange circles).
[Fig1. Site of skeletal maturity indicators]