Prevalence of Developmental Dysplasia of the Hip in Neonates with Congenital Talipes Equinovarus: A Case-Control Study from Iran

Purpose: This study investigates the relationship between congenital talipes equinovarus (CTEV) and developmental dysplasia of the hip (DDH), two distinct pediatric musculoskeletal conditions with emerging evidence of association. Given the importance of early DDH detection to avert long-term issues like pain, reduced mobility, and osteoarthritis, the research examines ultrasound screening using the Graf classification. Although effective as a diagnostic tool, its routine use in neonates with CTEV continues to be debated, providing vital insights for diagnostics. 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.