Neonatal foot deformities and their relationship to developmental dysplasia of the hip

Paton, R. W.; Choudry, Q

doi:10.1302/0301-620x.91b5.22117

Cited by 70 publications

(33 citation statements)

References 28 publications

(27 reference statements)

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“…One set, alluded to above, comes under ‘packaging’ disorders with late gestational age, high birth weight, high-tone primiparous womb, and abnormal positioning belonging to this theory. Congenital talipes equinovarus and congenital muscular torticollis are thought to draw their association with DDH from the same set of causes [19, 20]. An increased risk from vaginal delivery compared to caesarean section may imply a potential for exacerbation of latent instability during a tight and traumatic passage of a breech baby through the birth canal.…”

Section: Discussionmentioning

confidence: 99%

Epidemiology of developmental dysplasia of the hip within the UK: Refining the risk factors

Woodacre

Ball

Cox

2016

Journal of Children's Orthopaedics

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PurposeThe epidemiology and risk factors for developmental dysplasia of the hip (DDH) are still being refined. We investigated the local epidemiology of DDH in order to define incidence, identify risk factors, and refine our policy on selective ultrasound screening.MethodsWith a cohort study design, data were prospectively recorded on all live births in our region from January 1998 to December 2008. We compared data on babies treated for DDH with data for all other children. Crude odds ratios (ORs) were calculated to identify potential risk factors. Logistic regression was then used to control for interactions between variables.ResultsThere were 182 children born with DDH (with a total of 245 dysplastic hips) and 37,051 without. The incidence was 4.9 per 1000 live births. Female sex (adjusted OR 7.2, 95% confidence interval [CI] 4.6–11.2), breech presentation (adjusted OR 24.3, 95% CI 13.1–44.9), positive family history (adjusted OR 15.9, 95% CI 11.0–22.9) and first or second pregnancy (adjusted OR 1.8, 95% CI 1.5–2.3) were confirmed as risk factors (p < 0.001). In addition, there was an increased risk with vaginal delivery (adjusted OR 2.7, 1.6–4.5, p < 0.001) and post-maturity (OR 1.7, 1.2–2.4, p < 0.002).ConclusionsOne in 200 children born within our region requires treatment for DDH. Using both established and novel risk factors, we can potentially calculate an individual child’s risk. Our findings may contribute to the debate regarding selective versus universal ultrasound screening.Level of EvidencePrognostic Study: Level 1.

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Section: Discussionmentioning

confidence: 99%

Epidemiology of developmental dysplasia of the hip within the UK: Refining the risk factors

Woodacre

Ball

Cox

2016

Journal of Children's Orthopaedics

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“…Despite this presumed association, there are no agreed protocols for routine screening and the efficacy of screening hips in patients with CTEV remains undetermined [3,4]. Clinical examination alone has been shown to be inadequate in preventing late-presenting DDH [5].…”

Section: Introductionmentioning

confidence: 99%

Prevalence of developmental dysplasia of the hip in children with clubfoot

Chou

Ramachandran

2013

Journal of Children's Orthopaedics

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Purpose The relationship between congenital talipes equinovarus (CTEV) and developmental dysplasia of the hip (DDH) remains uncertain. The role of routine hip screening in children with CTEV is debated. A recent study has found a high incidence of DDH in patients with CTEV. The aim of our study was to determine the true prevalence of radiographic hip dysplasia and identify the need for routine hip screening in patients treated for CTEV. Methods From a single centre database of 165 children consisting of 260 CTEV, a prospective radiological prevalence study of 101 children was performed over a period of 3 months. A single anterior-posterior pelvic radiograph was performed at a minimum age of 5 months. The DDH was determined by a single senior investigator based on the age-adjusted acetabular index (AI) as described by Tonnis. Results There were no dislocations or subluxations. According to the age-adjusted AI, 16 children had 'light' dysplasia and one child had 'severe' dysplasia. The child with severe dysplasia was known to have DDH and had already undergone treatment. The 16 children with light dysplasia did not require any form of treatment. Conclusion Out of one hundred and one children with CTEV, only one had DDH requiring treatment. This is consistent with the majority of the literature supporting the premise that there is no true association between CTEV and DDH. We, therefore, feel that routine hip screening for children with CTEV is not supported by current evidence and cannot be recommended.

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“…Recently, however, there has been debate concerning the relationship between CTEV and DDH, and the efficacy of screening hips in these patients has been questioned. 7,8 We present an observational cohort study spanning 6.5 years of routine screening of the hips of neonates with CTEV.…”

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confidence: 99%

The association between clubfoot and developmental dysplasia of the hip

Perry

Tawfiq

Roche

et al. 2010

The Journal of Bone and Joint Surgery. British volume

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The association between idiopathic congenital talipes equinovarus (CTEV) and developmental dysplasia of the hip is uncertain. We present an observational cohort study spanning 6.5 years of selective ultrasound screening of hips in clubfoot. From 119 babies with CTEV there were nine cases of hip dysplasia, in seven individuals. This suggests that 1 in 17 babies with CTEV will have underlying hip dysplasia. This study supports selective ultrasound screening of hips in infants with CTEV.

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Neonatal foot deformities and their relationship to developmental dysplasia of the hip

Cited by 70 publications

References 28 publications

Epidemiology of developmental dysplasia of the hip within the UK: Refining the risk factors

Epidemiology of developmental dysplasia of the hip within the UK: Refining the risk factors

Prevalence of developmental dysplasia of the hip in children with clubfoot

The association between clubfoot and developmental dysplasia of the hip

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