Comparison Between Two Techniques of Capsulotomy During Capsulorrhaphy in Cases of Developmental Dysplasia of the Hip

N/AEnrolling By InvitationNCT06439147

Assiut University50 enrolled

Overview

comparison of the outcome between using U-shaped incision and T-shaped incision for capsulorrhaphy in management of Developmental dysplasia of the hip

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.

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

TREATMENT

Masking

SINGLE

Enrollment

Conditions

Developmental Dysplasia of the Hip

Interventions

U shaped capsular incision during capsulorrhaphyPROCEDURE

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

T-shaped capsular incision diuring capsulorraphyPROCEDURE

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.

Eligibility

Sex: ALLMin age: 1 YearMax age: 4 Years

Medical Language ↔ Plain English

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). * Patients who will undergo femoral shortening.

Locations (1)

Assiut university hospital

Asyut, Egypt

Outcomes

Primary Outcomes

Modified Mackay's criteria as a clinical evaluation method

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

Time frame: 1 year

Secondary Outcomes

Operative time ofcapsulorrhaphy

calculate the time needed to close the capsule of the hip

Time frame: 1 year

Number of stitches taken during capsulorrhaphy

Time frame: 1 year

any complication detected

Recurrent dislocation,pain,Avascular necrosis of the hip

Time frame: 1 year

Data from ClinicalTrials.gov

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