[Long-term results in pediatric orthopedics].

Whether to treat deformities in childhood or even to operate on them is a difficult decision which may affect a patient's whole life. Most important is a sound knowledge of the natural course. Many 'deformities' are just normal variants, and others improve during the growth period, but some get worse and may cause damage in later life. However the outcome of operations is not always certain. Recurrence may occur as well as overcorrection; therefore, the long-term prognosis, with or without treatment, must be the guideline for indications. If an operation is considered, timing and extent of a correction are decisive. On the grounds of long-term outcome studies, guidelines can be established for the treatment of different diseases and deformities: upper extremities [dysmelia, elbow], spine [scoliosis, Scheuermann's disease, spondylolisthesis], hip (congenital dysplasia, Perthes' disease, slipped epiphysis), knee and feet (flatfoot, pes equinovarus).