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Reliability of a New Radiographic Classification System for Developmental Dysplasia of the Hip

Volume 6 | Issue 1 | Jan – April 2020 | Page: 16-19 | B. Pasupathy, M. Sathish Authors : B. Pasupathy [1], M. Sathish [1] [1] Department of Orthopaedics and Traumatology, Rajiv Gandhi Government General Hospital, Chennai, TamilNadu India. Address of Correspondence Dr. M.Sathish, Institute of Orthopaedics and Traumatology, Rajiv Gandhi Government General Hospital, […]

Observational Study on Impact of Pediatric Foot Pathology and its Management in Ossification of Midfoot Tarsal bones

Volume 6 | Issue 1 | Jan – April 2020 | Page: 7-10 | B. Pasupathy, M. Sathish Authors : B. Pasupathy [1], M. Sathish [1] [1] Department of Orthopaedics and Traumatology, Rajiv Gandhi Government General Hospital, Chennai, TamilNadu India. Address of Correspondence Dr. M.Sathish, Institute of Orthopaedics and Traumatology, Rajiv Gandhi Government General Hospital, […]

Reliability of a New Radiographic Classification System for Developmental Dysplasia of the Hip

Observational Study on Impact of Pediatric Foot Pathology and its Management in Ossification of Midfoot Tarsal bones

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Reliability of a New Radiographic Classification System for Developmental Dysplasia of the Hip

Volume 6 | Issue 1 | Jan – April 2020 | Page: 16-19 | B. Pasupathy, M. Sathish

Authors : B. Pasupathy [1], M. Sathish [1]

[1] Department of Orthopaedics and Traumatology, Rajiv Gandhi Government General Hospital, Chennai, TamilNadu India.

Address of Correspondence
Dr. M.Sathish,
Institute of Orthopaedics and Traumatology, Rajiv Gandhi Government General Hospital, Chennai Tamil Nadu India.
E-mail: drsathishmuthu@gmail.com

Abstract

The Tonnis radiographic classification for developmental dysplasia of the hip (DDH) has been widely used for grading the severity of the disease. By definition, this method requires the presence of an ossification centre, which can be delayed in appearance and eccentric in location at times. The International Hip Dysplasia Institute (IHDI) classification, a new classification system recently developed by the IHDI, answers the scenario unanswered by the Tonnis classification. This study aimed to validate its reliability in evaluating DDH with an ossification center and to compare the 2 classifications in evaluating all DDH hips. In total, the pelvic radiographs of 92 DDH patients (115 hips) between the ages of 6 and 48 months between 2014 and 2017 were assessed by 3 observers retrospectively using the 2 classifications. Intraobserver and interobserver variations were evaluated using Cohen’s kappa method and graded with Munro’s correlation strength categories. Both classifications showed excellent intraobserver and interobserver reliability. However, the IHDI demonstrated more interobserver reliability, especially for evaluating DDH without an ossification center. The IHDI classification exhibited good practicability in classifying the radiographic severity of DDH compared to the Tonnis classification, particularly in hips without an ossification center. Therefore, the IHDI classification seems to be the expanded version of the Tonnis classification and can be used as a reliable tool in the management of the early stages of DDH to stage the disease and plan treatment accordingly.
Keywords: Tonnis classification, IHDI classification, DDH.

References

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How to Cite this Article: Pasupathy B, Sathish M.| Reliability of a New Radiographic Classification System for Developmental Dysplasia of the Hip.| International Journal of Paediatric Orthopaedics | Jan-April 2020; 6(1): 16-19.

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Observational Study on Impact of Pediatric Foot Pathology and its Management in Ossification of Midfoot Tarsal bones

Volume 6 | Issue 1 | Jan – April 2020 | Page: 7-10 | B. Pasupathy, M. Sathish

Authors : B. Pasupathy [1], M. Sathish [1]

[1] Department of Orthopaedics and Traumatology, Rajiv Gandhi Government General Hospital, Chennai, TamilNadu India.

Address of Correspondence
Dr. M.Sathish,
Institute of Orthopaedics and Traumatology, Rajiv Gandhi Government General Hospital, Chennai Tamil Nadu India.
E-mail: drsathishmuthu@gmail.com

Abstract

As Julius Wolff in 1868 stated that every change in the form or function of a bone is followed by adaptive changes in its internal architecture and its external shape, we conducted an observational study radiologically in the children attending our hospital to note the trend in the ossification of the midfoot tarsal bones in normal and in pathological conditions and determine the impact that each disease levies on the bone re-modelling and maturation. We studied the ossification status of 402 foot with a sex ratio of M: F 2.86:1. The mean age of the children enrolled in the study is 50.23 months (range 0.3-144). There was equal distribution of the side of the foot studied. The pathological distribution of the foot was as follows: 278 Club Foot, 88 Normal Foot, 16 Congenital Vertical Talus, 8 Flat foot, 4 Coalition of tarsal bones, 4 Cerebral Palsy, 4 Hereditary Sensory and Autonomic Neuropathy. We compared the rate of ossification of pathological foot with the normal foot. Out of the 278 club foot involved in the study 20 underwent Tibialis Anterior Tendon Transfer (TATT) for residual deformity following Ponsetti correction. We found that there is a significant delay in the ossification of the medial midfoot tarsal bones like intermediate and medial cuneiform and navicular in club foot cases. Intervention in the form of Ponsetti casting and tendon transfer significantly altered the rate of ossification of the tarsal bones. This establishes the pathology involved in the disease like club foot which results in the varus positioning of the foot in children resulting in faster ossification of the lateral midfoot tarsal bones and significant delay in the ossification of the medial midfoot tarsal bones comparing to the normal population of same age. By procedures like Ponsetti and TATT which normalises the weight bearing of all the midfoot tarsal bones resulted in a significant change in the rate of ossification of the midfoot tarsal bones compared to the untreated patients of same age.
Keywords: Foot Ossification, Club Foot, TATT, Ponsetti casting.

References

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How to Cite this Article: Pasupathy B, Sathish M.| Observational Study on Impact of Pediatric Foot Pathology and its Management in Ossification of Midfoot Tarsal bones.| International Journal of Paediatric Orthopaedics | Jan-April 2020; 6(1): 7-10.

Half Sized Blog Element (Single Author Style)

Half Sized Blog Element (Multi Author Style)

Reliability of a New Radiographic Classification System for Developmental Dysplasia of the Hip

Observational Study on Impact of Pediatric Foot Pathology and its Management in Ossification of Midfoot Tarsal bones

Reliability of a New Radiographic Classification System for Developmental Dysplasia of the Hip

Observational Study on Impact of Pediatric Foot Pathology and its Management in Ossification of Midfoot Tarsal bones

Full Sized Blog Element (Big Preview Pic)

Reliability of a New Radiographic Classification System for Developmental Dysplasia of the Hip

Authors : B. Pasupathy [1], M. Sathish [1]

Abstract

References

(Abstract) (Full Text HTML) (Download PDF)

Observational Study on Impact of Pediatric Foot Pathology and its Management in Ossification of Midfoot Tarsal bones

Authors : B. Pasupathy [1], M. Sathish [1]

Abstract

References

(Abstract) (Full Text HTML) (Download PDF)

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