Gait analysis of adult patients with complete congenital dislocation of the hip.

ABSTRACT

Comprehensive gait analysis is valuable in understanding the performance of patients with lower limb disorders. The gait pattern of adult patients with untreated congenital dislocation of the hip (CDH) has not yet been reported. We studied the gait pattern in nine women (mean age 31.4 years) with Crows group IV CDH. Six had unilateral and three had bilateral involvement. They were not treated during childhood and had no pain at the time of study. A control group comprised 15 normal female subjects of the same age group. Gait was studied using a motion-analysis system, force plateforms, and computer calculation during level walking. Common abnormal gait patterns seen in patients with both unilateral and bilateral CDH were slower walking velocity, which was due to a shorter stride length, less forward tilting of the pelvis, insufficient flexion, and excessive internal rotation of the hips. The patients with unilateral CDH had a shorter step length, lower pelvis, a lateral shift of the ground reaction force, decreased maximum adduction moments of the hip and knee on the diseased side, and increased maximum adduction moments of the hip and knee on the unaffected side. This asymmetry may have been due to leg length inequality. Thus, correlation of the leg length discrepancy may be important for unilateral CDH patients in improving their gait.