Should we Continue to Screen for Developmental Dysplasia of the Hip in Clubfoot? Our Experience and Review of the Literature
Volume 7 | Issue 2 | May-August 2021 | Page: 07-11 | Teixeira R, Ovídio J, Arcangelo J, Campagnolo J, Tavares D
Authors: Teixeira R [1], Ovídio J [2], Arcangelo J [2], Campagnolo J [2], Tavares D [2]
[1] Hospital São Francisco Xavier, Lisbon, Portugal.
[2] Hospital Dona Estefânia, Lisbon, Portugal
Address of Correspondence
Dr. Raquel Teixeira,
Rua dos Quartéis 80, r/c direito, 1300-483 Ajuda, Lisbon, Portugal.
E-mail: rt.corda@gmail.com
Abstract
Objective: The association between clubfoot and developmental dysplasia of the hip (DDH) remains uncertain, with only a few studies linking both. However, clubfoot is considered as a risk factor for DDH. The aim of this study was to determine the incidence of DDH and evaluate the need for routine hip imaging in our population of children with clubfoot.
Methods: Retrospective analysis of all patients treated for clubfoot in our center between 2010 and 2019. We included patients with hip imaging for DDH in the first 12 months of life.
Results: There were 108 children with clubfoot who underwent DDH screening. 92 had idiopathic clubfoot and 16 had syndromic clubfoot. Of the patients with idiopathic clubfoot, 2 (2.2%) had DDH; one had a clinically unstable hip and the other patient underwent hip screening on account of the clubfoot alone. Among patients with syndromic clubfoot, 3 (18.8%) had developmental dysplasia of the hip. Two of them had an abnormal hip examination while the other had normal hip clinical examination but other established risk factors for DDH.
Conclusion: A targeted ultrasound or radiological screening programme for DDH in idiopathic clubfoot diagnosed hip dysplasia in only 1 child that would have otherwise been missed by clinical examination alone. We conclude that hip imaging is not warranted in children with idiopathic clubfoot and regular clinical screening may suffice. In syndromic clubfoot, due to the higher incidence of DDH, we recommend specific ultrasound screening even in the presence of a normal hip examination.
Keywords: Clubfoot, Screening, Developmental dysplasia of the hip.
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| How to Cite this Article: Teixeira R, Ovídio J, Arcangelo J, Campagnolo J, Tavares D | Should We Continue to Screen for Developmental Dysplasia of the Hip in Clubfoot? Our Experience and Review of the Literature | International Journal of Paediatric Orthopaedics | May-August 2021; 7(2): 07-11. |
