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Evaluation of a Modified CE Angle Measurement to Evaluate Developmental Dysplasia of the Hip

Author(s): KS Gather, C Putz, A El-Zeneiny, T Dreher, S Hagmann


Background: The center edge-angle of Wiberg became one of the main tools to evaluate the lateral coverage of the femoral head in patient from 4 to 75 years. One limitation is the difficulty to define a reliable and accurate center of the femoral head in younger patients. With the improvement of conservative and surgical techniques in the treatment of DDH children are increasingly younger than 4 years at the time of treatment. Thus, it is necessary to have a reliable method to help decision making and to evaluate therapeutic success at this age.

Materials and Methods: Anterior-posterior pelvic radiographs of 33 children (65 hips) aged 4 to 16 years, that had been presenting with developmental hip dysplasia (39/65) or coxitis fugax (11/65) in our pediatric orthopedics outpatient clinic were analyzed in a retrospective analysis. The CE-angle of Wiberg and the modified CE-angle were measured.

Results and Conclusion: X-rays were analyzed by a student, a resident, and an orthopedic specialist. There was a very strong correlation between all three assessors (p<0.001). The reliability of the CE-angle of Wiberg and the modified CE-angle were both excellent with a Cronbach-alpha of 0.92 and 0.912, respectively. Femoral head coverage is one of the most significant prognostic factors for the development of the hip. Therefore, a radiographic tool valid for very young children needs to be established. The modified CE-angle is promising in this regard.