Purpose: The aim of this study was to determine the prevalence of developmental dysplasia of the hip (DDH) in preterm infants with maternal risk factors. Methods: A prospective review of the medical records and ultrasound (US) scans of all preterm infants at one tertiary-care children's hospital was completed to identify all premature infants without any infantile risk factors at a particular time frame. We consecutively evaluated 421 babies (842 hips) who satisfied the criteria for inclusion. Hip US images were classified according to Graf. Results: Overall, one hip was diagnosed as DDH (Graf type 2c). Female infants had significantly lower alpha angles (70.2 ± 6.6 and 71.4 ± 4.4 for females and males, respectively) ( P = 0.033). There was no correlation between oligohydramnios and alpha and beta angles and hip sides ( P = 0.345 and P = 0.789 for left and right hips, respectively). US examination of the infants revealed no differences between the alpha and beta angles of the hips and birth weight and age at gestation. Although it was statistically not significant, US evaluation of left hips among singletons demonstrated one immature hip ( P = 0.864) and that of right hips demonstrated one immature hip for both singletons and twins ( P = 0.904). Conclusions: Prematurity with or without maternal risk factors does not have an effect on DDH.

Objective: The treatment of diabetic hindfoot ulcers is a challenging problem. In addition to serial surgical debridements, hyperbaric oxygen therapy and local wound care play important roles in the surgeon’s armamentarium, for both superficial infection and gangrene of the soft tissue, often complicated by osteomyelitis of the calcaneus. The purpose of this study was to evaluate the results of an aggressive approach from diagnosis to treatment of calcaneal osteomyelitis in foot-threatening diabetic calcaneal ulcers. Methods: The study included 23 patients with diabetic hindfoot ulcers who were treated with radical excision of the necrotic tissue and application of circular external fixation. The treatment protocol was a combination of magnetic resonance imaging (MRI)-guided debridement of the necrotic tissues and application of an Ilizarov external fixator in plantarflexion to decrease the soft-tissue defect. Primary outcome measures were total cure of infection and obvious healing of the osteomyelitis at 12 weeks determined by MRI, and clinical cure through objective assessment of the appearance of the wound. Results: The wounds healed in 18 of the 23 patients (78%), partial recovery occurred and subsequent flap operation was performed in three patients (13%), and below-the-knee amputation was performed in two patients (9%). Conclusions: This surgical protocol is effective in ameliorating diabetic hindfoot ulcers with concomitant calcaneal osteomyelitis, and satisfactorily reduces the need for amputation.