Ossification Ages

Proximal Humerus
1. 3 centres of ossification
a. Humeral Head – Ossifies @ 6 months
b. Greater Tuberosity – Ossifies @ 3 years
c. Lesser Tuberosity – Ossifies @ 5 years
d. Coalesce @ 6-7 years
2. 80% of growth at proximal physis
a. closes @
i. 14-17 years for girls
ii. 16-18 years for boys

Clavicle
1. 1st to ossify
b. intramembranous ossification
c. @ 5-6 weeks gestation, medially and laterally
2. secondary centres
d. endochondral ossification
e. Medial epiphysis
i. 80% of growth
ii. ossifies between age 12-19 years
iii. fuses by age 22-25 years (last bone to fuse)
f. Lateral epiphysis
i. Does not ossify until it fuses at age 19 years

Scapula
1. Body and spine ossify at birth
2. Centre of coracoid
a. Ossify @ 1 year
3. Base of coracoid and upper ¼ of glenoid
a. Ossify @ 10 years
4. Fuses by 15-16 years
5. Acromion
a. Fuses by 22 years from 5 centres
b. 5 Centres start to ossify at puberty
6. Vertebral border, inferior angle, and lower ¾ of glenoid
a. Ossify at puberty and fuse at 22 years

Elbow
1. CRITOE – 2mo-4-6-8-10-12
a. Capitellum
b. Radius
c. (In)
Medial epicondyle
d. Trochlea
e. Olecranon
f. (Ex)
Lateral epicondyle
Hip
1. Ossification
a. Proximal femur – week 7 in utero
b. Proximal femoral epiphysis – 4-8 months
c. Trochanter – 4 years
2. Fuses
a. Epiphysis – 18 years
b. Apophysis – 16-18 years

Knee
1. Ossification
a. Distal femur – 39 week of gestation
b. Proximal tibia – birth
c. Tibial tubercle – 7-9 years
d. Patella – 3-5 years
2. Fuses
a. Distal femur – 16-19 years
b. Proximal tibia – 16-19 years
c. Tibial tubercle – 15-17 years
3. Growth
a. 2/3 of growth of LE
b. Distal femur
i. 9 mm/year
c. Proximal tibia
i. 6 mm/year

Tibia
1. Ossification
a. Diaphyseal – 7 weeks gestation
b. Proximal – just after birth
c. Distal – second year of life
d. Medial malleolus
e. Tibial tubercle – 7-9 years
2. Fuses
a. Proximal – 16 years
b. Distal – 15 years

Foot
1. Talus
a. Ossification
i. 8 months in utero
2. Calcaneus
a. Ossification
i. 7 months in utero
ii. secondary centre at age 10
b. Fuses
i. Age 16