Developmental Dysplasia of the Hip: Prevalence and Correlation with Other Diagnoses in Physiotherapy Practice—A 5-Year Retrospective Review

Vasilcova, Veronika; AlHarthi, Moqfa; AlAmri, Nadrah; Sagat, Peter; Bartík, Peter; Jawadi, Ayman H.; Zvonař, Martin

doi:10.3390/children9020247

Cited by 9 publications

(15 citation statements)

References 31 publications

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“…The FPI-6 evaluate the foot as multi-segmental complex, in double leg support, characterizing DDH was diagnosed by the pediatric orthopedics clinic in KASCH using pelvic radiographs. In Saudi Arabia, a pelvic radiograph was performed by a radiography technician supervised by a radiology consultant, and the results are inserted in Best Care Medical System by a radiographic physician (Vasilcova, et al, 2022). The acetabular angle using the Hilgenreiner line should be <28º at birth.…”

Section: Methodsmentioning

confidence: 99%

Pilot study: Effect of Developmental Dysplasia of the Hip on the Gait and Feet Posture

Vasilcova

2024

StS

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Background: The objective of this pilot study was to assess the effect of Developmental Dysplasia of the Hip (DDH) on gait, in pediatric participants, between the age of one to four years. Few studies are investigating the effect of DDH on the walking pattern within the pediatric rehabilitation practice. From an early age, children are developing a longitudinal foot arch. Constantly changing pediatric foot posture must be assessed. Gait pattern and foot posture are one of the most common parental concerns. Methods: The retrospective review of gait analysis, performed on 410 lower limbs, took place in King Abdullah Specialized Children Hospital (KASCH) in Riyadh, Kingdom of Saudi Arabia, from April 2020 until September 2020. All participants were diagnosed with DDH by pediatric orthopedics physicians in KASCH. Gait analysis was done by a physical therapist twice within three months, using The Wee Glasgow Gait Index (WeeGGI) and foot assessment was done once using Foot Postural Index (FPI-6). The WeeGGI compares eleven gait parameters. Each parameter has a choice of three figures, where each one has a clear explanation and/or value. The FPI-6 evaluates the foot as multi-segmental complex, in double leg support, characterizing pronation with + (plus) and supination with - (minus) numbers. Scoring is 2 (two) points in all six factors it is divided into rearfoot and forefoot assessment in transverse, frontal/transverse, frontal, and sagittal planes. Results: From all gait analyses (n=410). We included only 292 (71%) lower limbs with DDH and had to exclude 60 (15%) after hip surgery, 30 (7%) with another diagnosis, 18 (4%) without conservative treatment of DDH, and 10 (3%) with age above 48 months. According to the scoring of the Wee Glasgow Gait Index within the optimum/normal limits (score 0 - zero), we had 50 (17%), mild deviation (score 1-11) 236 (81%), and gross deviation (score 12-22) had 6 (2%) limbs within first gait analysis. With second gait analysis, 40% of lower limbs were within optimum/normal limits, 60% with mild deviation in gait, and zero within gross deviation. Every limb assessment for gait had the Foot Postural Index as well. Within normal limits (0 till +5) we had 143 (49%) feet, pronation (+6 till +9) was presented in 97 (33%) and high pronation (more then +10) had 52 (18%) pediatric feet. This sample did not present supination (-1 till -4) or high supination (-5 till -12). Limping was observed within 102 (35%) of the legs. The frequency of W-sitting presented in 47% of the results. The first and second gait analysis suggest an effect of DDH on the gait with a small difference between the right and left leg, although the left side was affected more within both gait analyses. Conclusion: Pathological gait pattern with DDH was detected in 83% within the first gait analysis, 60% within the second gait analysis, and Foot Postural Index revealed pronation of 51% feet. Among Saudi participants, a relatively high effect of DDH on gait patterns is reported in this pilot study. Keywords: DDH, gait, FPI-6, physiotherapy, WeeGGI.

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Section: Methodsmentioning

confidence: 99%

Pilot study: Effect of Developmental Dysplasia of the Hip on the Gait and Feet Posture

Vasilcova

2024

StS

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“…The latter may be the result of greater sensitivity to estrogens in females, which explains the more frequent occurrence of the defect in girls. Pregnancy hormones have a relaxing effect on the ligaments, which in physiological conditions strengthen the walls of the joint capsule [3,4]. The most common symptoms of hip dislocation include: the absence of the femoral head in the acetabulum, which can www.fizjoterapiapolska.pl be felt by palpation: at the intersection of the femoral vessels with the inguinal ligament, the shift of the femoral trochanter above the line connecting the ischial tubercle with the anterior superior iliac spine, the socalled the Roser-Nelaton line; shortening of the relative length of the limb (measured from the anterior superior iliac spine to the medial malleolus), asymmetry of the gluteal folds, significant limitation of abduction and external rotation movements in the hip joint, positive pumping sign (moving of the thigh along the pelvic axis), positive Allis (Galleazzi) sign characterized by the asymmetry of the position of the horizontal line above the bent knee joints in the chair position, raised lower limbs, the child lying on his back (hips and knees bent to the angle of 90 degrees) [5].…”

Section: Introductionmentioning

confidence: 99%

The importance of systematic rehabilitation over 45 years of a patient with developmental dysplasia of the hip joint (case study)

Stefańska-Szachoń,

Kubsik-Gidlewska,

Krochmalski

et al. 2023

Fiz Pol

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Congenital hip dysplasia is a teratogenic defect and affects 2% of the population; It arises in the fetal period and can be caused by pathological factors from both the mother and the fetus. The hallmark of congenital hip dysplasia is an undeveloped, excessively shallow acetabulum that prevents stabilization of the femoral head, resulting in hip dislocation. In recent years, there has been a shift in understanding of this musculoskeletal defect, based on early clinical and ultrasound findings, to developmental hip dysplasia, which can present as hip subluxation or dislocation. This paper presents the stages of treatment of a patient with developmental hip dysplasia over a 45-year period, the course of rehabilitation, and the effects of improvement after the use of CD34+ stem cells.

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“…Hip dysplasia is a deformity that leads to structural instability and capsular laxity. DDH can result in developmental abnormalities in terms of mechanical difficulties, a displacement of the joint (i.e., subluxation or dysplasia), additionally, malformed growth and can eventually cause arthritis if left untreated [ 3 ]. Early diagnosis in the first few months from birth can drastically improve healing, render surgical intervention unnecessary and reduce the bracing time [ 4 ].…”

Section: Introductionmentioning

confidence: 99%

Detection of developmental dysplasia of the hip in X-ray images using deep transfer learning

Fraiwan

Al-Kofahi

Ibnian

et al. 2022

BMC Med Inform Decis Mak

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Background Developmental dysplasia of the hip (DDH) is a relatively common disorder in newborns, with a reported prevalence of 1–5 per 1000 births. It can lead to developmental abnormalities in terms of mechanical difficulties and a displacement of the joint (i.e., subluxation or dysplasia). An early diagnosis in the first few months from birth can drastically improve healing, render surgical intervention unnecessary and reduce bracing time. A pelvic X-ray inspection represents the gold standard for DDH diagnosis. Recent advances in deep learning artificial intelligence have enabled the use of many image-based medical decision-making applications. The present study employs deep transfer learning in detecting DDH in pelvic X-ray images without the need for explicit measurements. Methods Pelvic anteroposterior X-ray images from 354 subjects (120 DDH and 234 normal) were collected locally at two hospitals in northern Jordan. A system that accepts these images as input and classifies them as DDH or normal was developed using thirteen deep transfer learning models. Various performance metrics were evaluated in addition to the overfitting/underfitting behavior and the training times. Results The highest mean DDH detection accuracy was 96.3% achieved using the DarkNet53 model, although other models achieved comparable results. A common theme across all the models was the extremely high sensitivity (i.e., recall) value at the expense of specificity. The F1 score, precision, recall and specificity for DarkNet53 were 95%, 90.6%, 100% and 94.3%, respectively. Conclusions Our automated method appears to be a highly accurate DDH screening and diagnosis method. Moreover, the performance evaluation shows that it is possible to further improve the system by expanding the dataset to include more X-ray images.

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Developmental Dysplasia of the Hip: Prevalence and Correlation with Other Diagnoses in Physiotherapy Practice—A 5-Year Retrospective Review

Cited by 9 publications

References 31 publications

Pilot study: Effect of Developmental Dysplasia of the Hip on the Gait and Feet Posture

Pilot study: Effect of Developmental Dysplasia of the Hip on the Gait and Feet Posture

The importance of systematic rehabilitation over 45 years of a patient with developmental dysplasia of the hip joint (case study)

Detection of developmental dysplasia of the hip in X-ray images using deep transfer learning

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