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.
We report our experience at the Pediatric Hospital “Ricardo Gutierrez” in Buenos Aires. 11 diplegic patients (8 male, 3 female) who presented severe neurological valgus feet were treated with the Dennyson Fulford technique between 1996 and 2000. 7 patients had a bilateral deformity and 4 unilateral deformity . Patients’ ages averaged 9.5 years (range, 7–12 years). The average follow up was 2 years and 3 months (range, 7 months–5 years). We took into consideration the following parameters to evaluate the results: 1- hind foot position, 2- adaptation to the orthosis 3- pain. The results were excellent in 10 feet, good in 6 feet and poor in 2 feet. The results obtained with the subtalar fusion using a screw for fixation coupled with bone graft were considered satisfactory on obtaining 88% of good and fair results and a good acceptance among patients. We consider that the Dennyson Fulford technique allows an proper reduction with few complications and we emphasize it as the best option among other current surgical techniques for this pathology.
