Is There a Difference in Femur Length Between Neglected Developmental Dysplasia of The Hip (DDH) And Contralateral Normal Hip-Femur Length: A Radiographic Study

Abstract

Bashir R. Al-Enazi, Mohammed H. Al-Rumaih, Mohammad A. Almalki, Sayaf H. Al-Shareef, Al-Baraa B. AlEnazi and Mamoun K. Kremli

Background and Aim: There are several anatomical problems with the hip joint that are associated with developmental dysplasia (DDH), such as the femoral head being out of place in relation to the acetabulum. First-born status, female sex, a positive family history, breech presentation, and oligohydramnios are all risk factors for preterm labor and birth. DDH severity has been graded using a variety of classification systems, including the Crowe classification, the Hartofilakidis classification, and the Eftekhar and Kerboul classification. The purpose of this study was to determine whether there is a difference in femur length between patients with neglected developmental dysplasia of the hip (DDH) and the normal femur.

Materials And Methods: This is a case series study of 14 patients with Unilateral DDH who did not have surgery. Between January 2017 and December 2020, data were retrieved and obtained from our hospital’s picture archiving and communication system (P.A.C.S). A Pelvis x-ray and a Full-Length Femur x-ray were taken for those patients. As a radiological landmark, a fulllength film from the tip of the greater trochanter to the intercondylar space was used in this study. The following were the inclusion criteria: 1. The patient must be an adult who is at least 18 years old. 2. The deformity should only occur on one side (Unilateral DDH). 3. They had never had surgery before. 4. Crowe types III and IV

Results: The mean age of the patients was 34 (SD 12.4) years, with females outnumbering males (71.4 % vs 28.6 %). Additionally, the mean length of the affected femur was 41.6 (SD 3.88) and the mean length of the normal femur was 42.2. (SD 4.08). When we compared the baseline characteristics of patients by age group (35 years vs 35 years), we discovered that the BMI of the older age group (35 years) was statistically significantly higher than the younger age group (35 years) (P-value =0.028)

Conclusion: As a result of our study, we found an approximately 1 to 2 cm difference in femur length between patients with unilateral DDH and normal hip, which was correlated with age and body mass index (BMI). Preoperative considerations for unilateral DDH include taking a long film of both femurs to determine their relative length differences. This will assist in determining the amount of subtrochanteric femoral osteotomy to perform.

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