Vertebral fractal analysis adds little beyond age and sex for skeletal maturation staging

In 923 adolescents, vertebral body fractal dimension (FD) on cephalograms added only 0.6% accuracy (77.8% vs 77.2%) for classifying skeletal growth phases versus age and sex alone. Chronological age and sex remained the primary predictors.

• Retrospective analysis of 923 individuals (7–18 years) using lateral cephalograms and hand-wrist radiographs as the reference standard.
• The full model (age, sex, FD) achieved 77.8% classification accuracy; Nagelkerke R² improved only 0.011 over the age-and-sex-only model.
• Single-center, retrospective design; modest FD contribution requires external validation before clinical adoption.

RadPigeon summaries are original and for information only. They are not clinical advice.