US Screening for DDH and Spinal Abnormalities in Idiopathic Clubfoot

Backround:
There are conflicting evidence regarding prevalence of hip dysplasia and clubfoot as well as neurogenic etiology for clubfoot.

Method:
We conducted a retrospective analysis of our clubfoot patients from 2000 to 2015 to evaluate the incidence of DDH and spinal cord anomalies using a universal us screening. Children were screened for hip dysplasia and spinal anomalies as part of our routine evaluation.

Results:
We had 333 children included in our study all of them underwent hip US according to Gaff`s method and spinal US.

We had 4 cases of children suspected with hip dysplasia on examination due to limited hip abduction. Hip US was IIB in all. We made pelvis AP X ray that showed acetabular dysplasia but none had dislocation. 3 of them treated with abduction pillow and casting of their legs according to Ponseti. One had only follow up. All 4 of them had complete resolution with normal pelvis x ray at last follow up

Conclusion:
Is that there is no increased risk of hip dysplasia in children with idiopathic club foot. In our clinic children with dislocated hips and clubfoot usually are syndromic and the association of true DDH and clubfoot is highly suggestive of syndromic clubfoot

None of the children were found to have pathology in the spine US

No children had hip problem or spinal abnormality at the last follow up 5-20 years

Conclusion

Children with idiopathic clubfoot do not need screening for spinal abnormality on admission

We did not found increased prevalence between DDH and clubfoot. Children with dislocated hip and clubfoot are usually syndromic as MMC arthrogryposis Larsen syndrome and other chromosomal abnormalities we believe that the association of dislocated hip and DDH is associated with non-idiopathic clubfoot.