Is Congenital Talipes Equinovarus a Risk Factor for Developmental Dysplasia of the Hip?

Background and Objectives: Although congenital talipes equinovarus (CTEV) and developmental dysplasia of the hip (DDH) have been associated with certain common intrauterine factors, the relationship between them remains controversial. The aim of this study was to evaluate whether CTEV represents a significant risk factor for DDH. Materials and Methods: Data from 3569 newborns who underwent hip ultrasonographic screening between 2010 and 2024 were retrospectively reviewed. Infants diagnosed with true idiopathic CTEV managed with Ponseti serial casting were classified as the “CTEV group”, while secondary cases (e.g., arthrogryposis, neuromuscular conditions) were excluded. DDH was defined as hips initially classified as Graf Type 2a that failed to mature to Type 1 by 3 months, as well as initial Graf Types 2b, 2c, D, 3, or 4. Hips initially classified as Type 2a that spontaneously matured to Type 1 within 3 months without treatment were considered normal. The relationships among sex, presence of CTEV, and DDH were analyzed using Fisher’s exact test and logistic regression analysis. Results: Of all participants, 54.7% were female and 45.3% were male. The overall prevalence of DDH was 4.8%. Male sex was identified as a significant protective factor against DDH (p < 0.001; OR = 0.32, 95% CI: 0.23–0.47). The presence of CTEV was not identified as a significant risk factor for DDH (OR = 0.86, 95% CI: 0.12–6.45; p = 0.884). Stratified analyses by sex also showed no statistically significant association between CTEV and DDH. Conclusions: Although CTEV is a distinct foot deformity diagnosed clinically, our findings demonstrate that CTEV was not identified as an independent risk factor for DDH. While these findings do not demonstrate an increased risk of DDH in infants with CTEV, the small number of CTEV cases limits statistical precision, resulting in a wide confidence interval. Therefore, these results should be interpreted with caution, and larger multicenter studies are warranted to clarify whether routine hip ultrasonography can be safely omitted in selective screening pathways.