Developmental Dysplasia of the Hip
Conditions
Brief summary
comparison of the outcome between using U-shaped incision and T-shaped incision for capsulorrhaphy in management of Developmental dysplasia of the hip
Detailed description
Developmental dysplasia of the hip: Developmental dysplasia of the hip is a spectrum of abnormalities of the developing hip joint that ranges from shallowness of the acetabulum to capsular laxity and instability to frank dislocation . Developmental dysplasia of the hip is relatively common, occurring in 1 of 1000 live births. When surgical intervention is decided, open reduction is needed to remove any obstacle that hinders hip reduction. Capsulorrhaphy is an essential step for minimizing instability of the hip after reduction The classic T-shaped capsular incision is done by two incisions: Vertical limb parallel to femoral neck axis and a transverse one parallel to the inguinal ligament resulting into two layers . Suturing them back is somewhat cumbersome after femoral head reduction. Therefore, the suggested technique utilizes a U-shaped incision to make re-suturing of the capsule easier with multiple stitches, and this study compares the outcome between using T-shaped incision and U-shaped incision for capsulorrhaphy after open reduction Femoral osteotomy or Pelvic osteotomy can be used in certain circumstances.
Interventions
PROCEDUREU shaped capsular incision during capsulorrhaphy
Incision of the capsule of the hip during open reduction of Developmental Dysplasia of the Hip,Incision is done with its base proximally. The transverse limb is 1 cm proximal to femoral neck base
PROCEDURET-shaped capsular incision diuring capsulorraphy
Incision of the capsule of the hip during open reduction of Developmental Dysplasia of the Hip done by two incisions: Vertical limb parallel to femoral neck axis and a transverse one parallel to the inguinal ligament resulting into two flabs.
Sponsors
Assiut University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
SINGLE (Subject)
Intervention model description
randomized clinical trial
Eligibility
Sex/Gender
ALL
Age
1 Years to 4 Years
Healthy volunteers
No
Inclusion criteria
* Patients older than 1 year and younger than 4 years * Unilateral or bilateral cases
Exclusion criteria
* Patients younger than 1 year and older than 4 years old * Secondary hip dislocation ,neuromuscular disorders (as cerebral palsy, myelodysplasia or arthrogryposis).
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Operative time of capsulorrhaphy | 1 year | calculate the time needed to close the capsule of the hip |
| Number of stitches taken during capsulorrhaphy | 1 year | — |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Modified Mackay's criteria as a clinical evaluation method | 1 year | Postoperative clinical evaluation Grade 1(Excellent):Painless,stable hip,no limp,more than 15 degrees of internal rotation Grade 2(Good):Painless,stable hip,slight limp or decreased motion;negative trendelenburg's sign Grade 3(Fair):Minimum pain,moderate stiffness;Positive trendelenburg sign Grade 4(Poor):Significant pain |
| any complication detected | 1 year | * Sublaxation * Recurrent dislocation * proximal femoral growth disturbance * Supracondylar femoral fracture * Infection |
Countries
Egypt
Outcome results
None listed