In the United States and other countries, one of the primary causes of medical errors in pediatric patients is the misdiagnosis of hip dysplasia. Thred diagnostic forms are described in children.

We consider that the following diagnostic algorithm should be applied: clinical assessment of both hips at birth, repeated clinical examination once a month to six months, ultrasonography from the sixth week to the fourth month performed by an experienced pediatric operator, in the event of doubt or unavailable programmed controls, radiography of both hips at the fourth month.

We present nine cases of hip dysplasia which illustrate this diagnostic approach.

Purpose of the study: From 1999 to 2004, 16 patients (25 hips) aged 2–9 years (average 5±3 years) were treated for spastic hips. The patients were diplegic (n=19 hips, 76%) and tetraplegic (n=6 hips, 24%). Pure pyramidal cerebral palsy patients with no history of seizure.

Material and methods: The surgical plan was: femoral osteotomy, periacetabular osteotomy (San Diego), tenotomy of the adductors and psoas, anterior hip reduction as needed. Pain, range of abduction, Reimmer’s index and acetabular index were noted.

Results: In the diplegic patients, outcome was good (70%), fair (23%), poor (7%). In tetraplegic patients, outcome was good (20%), fair (20%), poor (60%). Complications were avascular necrosis (n=1) and decubitus lesions (n=2).