THE PREDICTIVE VALUE OF CONGENITAL FOOT DEFORMITIES FOR THE DEVELOPMENTAL DISPLACEMENT OF THE HIP (DDH)
Introduction: The aim of this work is to assess the relation between neonatal foot deformities and the developmental displacement of the hip (DDH).
Material and Methods: A prospective survey has been conducted in the Neonatal Unit at the Clinic of Gynecology and Obstetrics and the Clinic of Orthopedics and Traumatology of the University Clinical Centre Tuzla during the period between August 30th, 2011 and April 30th, 2012. In this period 2678 babies were born and the survey was conducted among 450 newborns. A clinical and ultrasound examination of hips was conducted among all the newborns on their day of birth. The diagnosis for developmental displacement of the hip was set with the help of the clinical and ultrasound examination of the hips. Through clinical examination the instability of the hips was recorded as well as the deformity of the foot (pes equinovarus, metatarsus adductus, pes calcaneus).
Results and Discussions: The results of the survey have shown that the congenital foot deformities have a significant predictive value for the developmental displacement of the hip. There were 9 (2%) newborns with pes equinovarus, 3 (0,6%) newborns with metatarsus adductus and 77 (17,1%) newborns with pes calcaneus. For pes equinovarus the positive predictive value (PPV) is 55,6% and the negative predictive value (NPV) is 78%; for pes calcaneus PPV is to 39% and NPV is 80,7%; metatarsus adductus did not have a statistical value in this survey.
Conclusion: Congenital foot deformities, pes equinovarus and pes calcaneus have a significant predictive value for the developmental displacement of the hip. Newborns who have this type of foot deformity should undergo and ultrasound hip examination within the first few days of their life.