Clubfoot and Congenital Muscular Torticollis Prevalence in Children Diagnosed with Developmental Dysplasia of Hip: Review of 594 DDH Patients

Background: Developmental dysplasia of the hip (DDH) refers to a spectrum of disease, including hips that are unstable, subluxated, dislocated, and/or has dysplastic acetabula. Feet deformities such as clubfoot were mentioned in the literature as associated congenital anomalies in DDH patient with variable results. Multiple studies reported the correlation between DDH and congenital muscular torticollis (CMT) at a rate between 20% and 29%. In this study we determined the overall prevalence of clubfoot and/ or CMT in children who were diagnosed as idiopathic DDH in our tertiary care hospital. Materials and methods: The charts of 594 patients diagnosed as idiopathic DDH between January 2007 and December 2014 were retrospectively evaluated in this study. Demographic data and patient’s history were obtained from medical files and pelvic X-rays of DDH patients associated with clubfoot and CMT were reviewed. The outcome was evaluated according to the DDH risk factors. Statistical analysis of the data was performed using Excel program (Microsoft Office version 2011). Results: Out of 594 DDH patients; male were 105 (17.7%), and female 489 (82.3%). Bilateral DDH was found in 252 patients (42.4%), left DDH in 180 patients (30.3%), and right DDH in 162 patients (27.3%). None of the cases had CMT, while 11 patients (1.9%) had clubfeet. All DDH patients with clubfeet but one, showed severe form of DDH; Tonnis classification type IV. Conclusion: Although the association between DDH and clubfoot and/or CMT has been reported in literature with variant results, careful clinical examination is recommended to detect such disorders that can be treated earlier.