At what age do all carpal (wrist) bones develop?

From the Research

All carpal bones in the human wrist develop completely by early adulthood, with complete ossification typically occurring by 15 years of age in females and 17 years in males. The process begins during fetal development, but ossification (bone formation) of the carpal bones occurs postnatally. At birth, all eight carpal bones (scaphoid, lunate, triquetrum, pisiform, trapezium, trapezoid, capitate, and hamate) are present as cartilage models. Ossification begins with the capitate and hamate around 2-3 months of age. The remaining carpal bones ossify in a predictable sequence: triquetrum (2-3 years), lunate (3-4 years), scaphoid, trapezium and trapezoid (4-6 years), and finally the pisiform (9-12 years) 1.

This sequential development explains why wrist injuries in children often involve growth plate injuries rather than the fractures commonly seen in adults with fully ossified carpal bones. Understanding this developmental timeline is important for properly interpreting pediatric wrist radiographs and distinguishing normal development from pathology. The use of image analysis from computed tomography (CT) scans has been shown to be a useful method for assessing bone maturation, with significant correlations between carpal bone volume and age 2, 3.

Key points to consider when assessing carpal bone development include:

• Ossification begins with the capitate and hamate around 2-3 months of age
• The remaining carpal bones ossify in a predictable sequence
• Complete ossification of all carpal bones typically occurs by 15 years of age in females and 17 years in males
• Understanding this developmental timeline is important for properly interpreting pediatric wrist radiographs and distinguishing normal development from pathology
• Image analysis from CT scans can be a useful method for assessing bone maturation 4.

It is essential to prioritize the most recent and highest quality study when making a definitive recommendation, and in this case, the study by 1 provides the most relevant information on carpal bone development.