The treatment of developmental dysplasia of the hip (DDH) remains challenging, yet recent advances have refined our understanding of how best to survey for the condition during infancy, minimize complications during early treatment, and refine the selection of patients who can best benefit from hip preservation surgery. The ideal continued target would be to prevent missed hip dislocations or dysplasia during the infant period, prevent avascular necrosis (AVN) during early treatment, and decrease the incidence of total hip arthroplasty in adulthood related to undertreated DDH, The goal of the treatment is to achieve a concentric reduction of the femoral head into the acetabulum.

it is an operative technique to secure the femoral head after reduction in cases of developmental dysplasia of the hip

Operative technique:

The surgery will be accomplished under a general anesthesia.

An addition to the steps of the open reduction, the following were done:

1. Identification of ligamentum teres
2. ligamentum teres tenodesis

Inclusion Criteria:

• Patient with Developmental dysplasia of the hip (DDH) with :

  • Age: from 9 months -5 years old.
  • Virgin DDH.
  • Failed closed reduction in the management of DDH.
  • Failed open reduction through medial approach in the management of DDH

Exclusion Criteria:

• • Paralytic hip dislocation .

  • Post septic hip dislocation.
  • Traumatic hip dislocation .
  • Age : below 9 months or above 5 years.
  • Refusal to participate in this study.

The patients will be examined for:

1. Length of both lower limbs in relation to each other.
2. Length of both lower limbs according to patient age.
3. Presence of hump related to the outer surface of the hip
4. Presence of pain, abnormal gait, Trendlenburg test Radiographic evaluation (antero posterior and frog pelvis views)

An addition to the steps of the open reduction, the following were done:

1. Identification of ligamentum teres
2. ligamentum teres tenodesis