Journal of Epidemiology and Public Health
ISSN: 3065-9078 | DOI: 10.64030/3065-9078
Shahab Ilka
Background Congenital talipes equinovarus (CTEV), commonly known as clubfoot, and developmental dysplasia of the hip (DDH) are distinct pediatric musculoskeletal conditions. Despite their separate classifications, evidence suggests an association between them. Early detection of DDH is critical to prevent long-term complications, including pain, mobility limitations, and osteoarthritis. Ultrasound screening using the Graf classification has emerged as a valuable diagnostic tool, though its routine use in neonates with CTEV remains debated.
Methods This case-control study involved 150 neonates diagnosed with idiopathic congenital clubfoot and 155 healthy controls at Bahonar Hospital, Kerman, Iran, between 2016 and 2021. Participants underwent pelvic ultrasound assessment based on the Graf classification system to evaluate acetabular morphology. Alpha and beta angles were measured bilaterally, and subgroup analyses by sex were performed. Statistical analysis utilized SPSS version 26, with p < 0.05 considered significant.
Results The prevalence of DDH in neonates with CTEV was 13.3%, significantly higher than in controls (p < 0.001). Alpha angles less than 60° were exclusively observed in the CTEV group, occurring in 26% and 27.3% of right and left hips, respectively. Beta angles greater than 55° were more prevalent in controls (61.9% vs. 16.7% for right hips; 59.4% vs. 14.7% for left hips). Notably, males exhibited nearly double the DDH prevalence compared to females (18.8% vs. 9.3%).
Conclusion Our findings indicate a significant association between CTEV and DDH, emphasizing the need for targeted ultrasound screening in neonates with clubfoot. Future research should focus on elucidating the underlying mechanisms linking these conditions and refining screening protocols.