Introduction: Calcaneal lengthening osteotomy as a treatment for severe flat foot was described by Evans (1975) and his indications were expanded by Mosca (1995).

Materials and methods: We reviewed 28 feet operated on in 21 patients with neuromuscular processes (17) and with flat foot-valgus associated with congenital short Achilles tendon (11). The mean age was 12.2 (6–18) and mean follow-up was 7.3 years (4–11). In all cases the associated Achilles tendon was lengthened. We evaluated the subjective and objective clinical results (Kitaoka, 1994) and the radiological parameters.

Results: Subjective clinical: excellent and good 89.28% (100% in neuromuscular, 72.7 in short Achilles tendon). Objective clinical: (preop 64.25, postop 90.06 at 3 years, 86.13 at 7 years). The worsening of outcomes was due to three fair or poor results in the short Achilles tendon group (one required triple bone fusion).

All but one presented complete subtalar mobility. Normal alignment in all but one, with slight valgus; none in varus.

Conclusions: This surgical procedure gave excellent long-term results: subjective, nearly 90% excellent; objective: radiological anatomical correction, subtalar and tarsal mobility maintained. Its outcome was comparatively worse in the short Achilles tendon group than in the neuromuscular cases.

Introduction and purpose: There is a controversy about the value and usefulness of the ultrasound screening of hips as well as about what population should be screened. It seems clear that ultrasound is the best method for early screening of developmental dysplasia in infants. The purpose of this paper is to assess the results of the semi-universal ultrasound screening of hips in infants.

Materials and methods: We evaluated the screening carried out of all girls and boys with risk factors delivered in our hospital (3/4 of those in the whole of Navarra) 1n 2001, 2002 and 2003. The number of newborns studied was 4144, 4199 and 4820 respectively. Ultrasounds were carried out when they were one month old. Diagnosed dysplasias accounted for between 6.19 and 6.27 per thousand newborns. Of all patients with diagnosed dysplasias, 4 girls (no boys) had to be operated on (adductor tenotomy and plaster cast).

Results and conclusions: The majority of diagnosed and treated dysplasias were found in breech babies, babies with a family history of the disease and especially in cases where there was no other sign suggesting the disease (only eight of them had had a positive Ortolani-Barlow). The lack of cases of late dysplasia has prompted us to rely on this type of screening since it has helped us reduce the amount of surgical procedures.