Prenatal Ultrasound Diagnosis of Congenital Talipes Equinovarus in Bogota (Colombia) Between 2003 and 2012.

INTRODUCTION: Congenital Talipes Equinovarus (CTEV) or clubfoot is one of the most common congenital abnormalities(1,2). Early diagnosis by means of ultrasonography allows an opportune intervention and improves the deformity's correction prognosis. GOAL: To describe patients diagnosed with CTEV by means of prenatal sonographies between 2003 and 2012 in Bogotá (Colombia) at both the Institute de Ortopedia Infantil Roosevelt (IOIR) and one of the authors' private office. METHODS: A descriptive, retrospective study on the focus population was made. The equality of the data of the quantitative variables in distance measure was analysed by the Kolmogorov-Smirnov test. For the variables "prenatal diagnoses" and "days from the start of the treatment" the Mann-Whitney U test was used. Finally, an analysis was made by means of the SPSS Statistics software package, version 18.0. RESULTS: 178 patients met the selection criteria. 34.3% of the patients had a prenatal diagnosis by ultrasonography (n=61). Regarding the number of prenatal ultrasounds performed, there were statistically significant differences between the patients with a CTEV prenatal diagnoses and those whose diagnoses came after birth, being higher in the first group (p<0.001). The number of days before the treatment started once the pre or postnatal diagnosis was done was also a subject of study. Significant differences were found in the treatment start between patients with a prenatal diagnosis (mean of 9.9 days) and those diagnosed after birth (mean of 30 days) (p<0.001). CONCLUSIONS: prenatal diagnosis by foetal ultrasonography contributes to an early detection of musculoskeletal abnormalities such as CTEV and promotes an early intervention of the patient.

Artritis séptica de cadera en niños: revisión de la literatura / Current concepts in septic arthritis in children: [review]

La artritis séptica de la cadera es una enfermedad que el gremio médico ha reconocido desde el siglo XIX. Inicialmente su mortalidad era cercana al 50 por ciento. Esta situación cambió con el advenimiento de los antibióticos, con los que la tasa de mortalidad se redujo a un rango entre 1 por ciento y 5 por ciento. Sin embargo, los pobres resultados y las secuelas, como la destrucción de la cabeza femoral o la osteomielitis crónica, siguen siendo frecuentes. Esta infección tiene una incidencia mayor en la edad neonatal y la lactancia temprana. De hecho, 60por ciento de los casos se registran en niños menores de un año. Los pilares que encontramos en nuestra revisión para un buen resultado son los mismos reportados en otras revisiones: un diagnóstico temprano, un abordaje quirúrgico oportuno con lavados articulares, y un uso racional, adecuado y personalizado de los antibióticos.

Septic arthritis of the hip has been known to the medical community since the nineteenth century. Its mortality rate was initially close to 50%, but with the advent of antimicrobial agents this number has come down to between 1% and 5% of cases. However, poor results and sequelae, like femoral head destruction or chronic osteomyelitis, are still frequent. This infection has a high incidence in the neonatal period and early infancy; in fact, 60% of cases are reported in patients less than one year of age. The cornerstones found in ourrevision of the literature for a good result are those previously described in other such reports: early diagnosis, prompt surgical treatment with appropriate hip debridement, and a rational, adequate and personalized use of antibiotics.