Relationship between flexible flat foot and developmental hip dysplasia

NewsBot · Apr 7, 2015

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Relationship between flexible flat foot and developmental hip dysplasia.
Ponce de León Samper MC, Herrera Ortiz G, Castellanos Mendoza C
Rev Esp Cir Ortop Traumatol. 2015 Apr 2

PURPOSE:
To evaluate the possible relationship between flexible flat foot and developmental hip dysplasia in children between six and 15 years of age.
METHOD:
Cross-sectional study including 65 patients that had undergone surgery due to residual hip dysplasia or hip dislocation and compared against 75 healthy patients. Flexible flat foot prevalence was measured in each group, with the results showing that 61% of the group with residual hip dysplasia or hip dislocation had this condition, vs. 12% in the healthy group. The statistical analysis shows that the chances of suffering from flexible flat foot, are five times greater in the hip dysplasia or hip dislocation group, than in the healthy group.
DISCUSSION:
There is no evidence in the literature showing a relationship between these two conditions, even though they have a common etiology. This study shows a potential measurable relation between this two conditions.
CONCLUSION:
Patients with hip dysplasia or dislocation may have a higher chance of presenting flexible flat foot during late childhood, adolescence and adulthood, a fact that suggests a relationship between these two pathologies. Also, patients who seek assistance for the first time because of a flexible flat foot condition without having been evaluated during the first year of life for hip dysplasia, would be better off if evaluated for residual hip dysplasia
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NewsBot · Jun 16, 2015

Pedobarographic Analysis Following Pemberton's Pericapsular Osteotomy for Unilateral Developmental Dysplasia of the Hip: An Observational Study
Xu, Chao; Yan, Ya-Bo; Zhao, Xiong; Wen, Xin-Xin; Shang, Lei; Huang, Lu-Yu; Lei, Wei
Medicine: June 2015 - Volume 94 - Issue 23 - p e932

Successful clinical and radiographic outcomes have been reported in patients with unilateral developmental dysplasia of the hip (DDH) following Pemberton pericapsular osteotomy (PPO). However, residual gait deviations are seen in both the affected and unaffected limbs. To date it is not known whether these deviations result in abnormal plantar pressure in such patients.

This study investigated this possibility by performing pedobarographic, clinical, and radiographic examinations after PPO in 20 patients (age: 102.5 ± 19.0 months) with unilateral DDH who underwent PPO at 34.2 ± 9.8 months of age. Plantar pressure was evaluated using the Footscan pressure plate (RsScan International, Olen, Belgium). Each foot was subdivided into 10 zones and peak pressure, force–time integral as a percentage of total FTI, and contact time as a percentage of total stance time was estimated. The minimum duration of follow-up was 24 months (mean: 68.3 ± 20.3 months). The data were compared with 20 age- and weight-matched healthy controls.

Despite clinical and radiographic examinations showing satisfactory results according to modified McKay and Severin criteria, significant differences in plantar pressure parameters were identified between the affected limbs, the unaffected limbs, and normal controls. No significant differences were found between patients classified as “excellent or good” and those rated as “fair” according to the modified Severin criteria.

Pedobarographic results showed the existence of the residual plantar pressure deviations during walking in patients treated with PPO for unilateral DDH. Longer follow-up will be needed to more fully evaluate the effect of these deviations on gait.
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NewsBot · Oct 3, 2020

Is foot deformity associated with developmental dysplasia of the hip?
Øyvind Håberg et al
Bone Joint J. 2020 Sep 23;1-5

Aims: To assess if congenital foot deformity is a risk factor for developmental dysplasia of the hip (DDH).

Methods: Between 1996 and 2012, 60,844 children were born in Sør-Trøndelag county in Norway. In this cohort study, children with risk factors for DDH were examined using ultrasound. The risk factors evaluated were clinical hip instability, breech delivery, a family history of DDH, a foot deformity, and some syndromes. As the aim of the study was to examine the risk for DDH and foot deformity in the general population, children with syndromes were excluded. The information has been prospectively registered and retrospectively analyzed.

Results: Overall, 494 children (0.8%) had DDH, and 1,132 (1.9%) a foot deformity. Of the children with a foot deformity, 49 (4.3%) also demonstrated DDH. There was a statistically significant increased association between DDH and foot deformity (p < 0.001). The risk of DDH was highest for talipes calcaneovalgus (6.1%) and club foot (3.5%), whereas metatarsus adductus (1.5%) had a marginal increased risk of DDH.

Conclusion: Compared with the general population, children with a congenital foot deformity had a significantly increased risk for DDH and therefore we regard foot deformity as a true risk factor for DDH.
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NewsBot · Feb 28, 2023

Pilot Study: Effect of Developmental Dysplasia of the Hip on
the Gait.
Veronika Vasilcová et al
Source

Background: The objective of this pilot study was to assess the effect of Developmental Dysplasia
of the Hip (DDH) on gait, in pediatric participants, between the age of one to four
years. Few studies are investigating the effect of DDH on the walking pattern within the
pediatric rehabilitation practice. From an early age, children are developing a longitudinal
foot arch. Constantly changing pediatric foot posture must be assessed. Gait pattern and
foot posture are one of the most common parental concerns.
Methods: The retrospective review of gait analysis, performed on 410 lower limbs, took
place in King Abdullah Specialized Children Hospital (KASCH) in Riyadh, Kingdom of Saudi
Arabia, from April 2020 until September 2020. All participants were diagnosed with DDH by
pediatric orthopedics physicians in KASCH. Gait analysis was done by a physical therapist
twice within three months, using The Wee Glasgow Gait Index (WeeGGI) and foot assessment
was done once using Foot Postural Index (FPI-6). The WeeGGI compares eleven gait
parameters. Each parameter has a choice of three figures, where each one has a clear explanation
and/or value. The FPI-6 evaluates the foot as multi-segmental complex, in double
leg support, characterizing pronation with + (plus) and supination with - (minus) numbers.
Scoring is 2 (two) points in all six factors it is divided into rearfoot and forefoot assessment
in transverse, frontal/transverse, frontal, and sagittal planes.
Results: From all gait analyses (n = 410). We included only 292 (71%) lower limbs with DDH
and had to exclude 60 (15%) after hip surgery, 30 (7 %) with another diagnosis, 18 (4%) without
conservative treatment of DDH, and 10 (3%) with age above 48 months. According to the
scoring of the Wee Glasgow Gait Index within the optimum/normal limits (score 0 – zero),
we had 50 (17%), mild deviation (score 1–11) 236 (81%), and gross deviation (score 12–22)
had 6 (2%) limbs within first gait analysis. With second gait analysis, 40% of lower limbs
were within optimum/normal limits, 60% with mild deviation in gait, and zero within gross
deviation. Every limb assessment for gait had the Foot Postural Index as well. Within normal
limits (0 till +5) 143 (49%) feet, pronation (+6 till +9) was presented in 97 (33%) and high pronation
(more then +10) had 52 (18%) pediatric feet. This sample did not present supination
(-1 till -4) or high supination (-5 till -12). Limping was observed within 102 (35%) of the legs.
The frequency of W-sitting presented in 47% of the results. The first and second gait analysis
suggest an effect of DDH on the gait with a small difference between the right and left leg,
although the left side was affected more within both gait analyses.
Conclusion: Pathological gait pattern with DDH was detected in 83% within the first gait
analysis, 60% within the second gait analysis, and Foot Postural Index revealed pronation
of 51% feet. Among Saudi participants, a relatively high effect of DDH on gait patterns is
reported in this pilot study.
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