Modified Hip Capsular Incision: an Easier Way to do Hip Capsulorrhaphy in Developmental Dysplasia of the Hip (DDH)

Study Overview
=================
Brief Summary
-----------------
Developmental dysplasia of the hip (DDH) is the commonest hip problem seen by pediatric orthopaedic surgeons (1). DDH refers to an abnormal configuration of, or relationship between, the femoral head and the acetabulum .Principals of surgical treatment of DDH, however, always include reduction and stabilization. These principals could be applied by conservative or surgical means (2). Goal of Treatment options to Obtain and maintain reduction without damaging femoral head. Surgical Stabilization might be required in cases with failed conservative treatment, residual dysplasia or older children with neglected DDH. Surgical stabilization is generally achieved by a reduction into a near anatomical position and a complementary capsulorrhaphy (3). In the classic T-shaped capsular incision, the vertical branch parallel to the axis of the neck and the horizontal branch 5 mm from the iliac insertion of the capsule, from anterior and downward to posterior and upward. Two flaps are thus obtained (4). It was noticed that doing capsulorrhaphy after head reduction is cumbersome with this technique because it needs shallow-curved needles while suturing in narrow field and sometimes the suture material gets avulsed from medial flab. A suggested technique by doing a modified incision to make re -suturing of the capsule easier with multiple stitches.

Detailed Description
-----------------
This Modified incision to make re -suturing of the capsule easier with multiple stitches.

Official Title
-----------------
Modified Hip Capsular Incision: an Easier Way to do Hip Capsulorrhaphy in Developmental Dysplasia of the Hip (DDH)

Conditions
-----------------
Developmental Hip Dysplasia

Intervention / Treatment
-----------------
* Procedure: Modified hip capsular incision


Participation Criteria
=================
Eligibility Criteria
-----------------
Inclusion Criteria: Age 1-7 years old Primary DDH Exclusion Criteria: Paralytic hip DX in cases of (Cerebral palsy,Meningomyelocele,Neuropathy or Myopathy) Recurrent cases of DDH

Ages Eligible for Study
-----------------
Minimum Age: 1 Year
Maximum Age: 7 Years

Sexes Eligible for Study
-----------------
All

Accepts Healthy Volunteers
-----------------
No

Study Plan
=================
How is the study designed?
-----------------

Design Details

Primary Purpose: Treatment
Intervention Model: Single Group Assignment
Interventional Model Description: prospective case series study
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: modified hip capsular incision<br>make re -suturing of the capsule easier with multiple stitches. | Procedure: Modified hip capsular incision<br>* modified incision to make re -suturing of the capsule easier with multiple stitches.<br>|

What is the study measuring?
-----------------
Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Feasibility of hip capsulorrhaphy | as regards operative time to do capsullorrhapy in minutes | intraoperative | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Any complications detected | as: infection -Recurrent dislocation -AVN | 1 year | 

 Terms related to the study
=================
Keywords Provided by Centre Hospitalier Valida
-----------------
DDH, Developmental hip dysplasia, Capsulorrhaphy