Treatment of developmental dysplasia of the hip (DDH) is still challenging, till now there is no any recent advances have refined our understanding of how best to survey for the condition during infancy and refine the selection of patients who can best benefit from hip preservation surgery.

Concentric positioning of femoral head into the acetabular cavity and adequate balance in growth between tri-radiate and acetabular cartilage are leading to adequate growth and development of the hip. Any alteration in these two conditions leads to a hip dysplasia & dislocation .

Treatment of developmental dysplasia of the hip (DDH) is still challenging, till now there is no any recent advances have refined our understanding of how best to survey for the condition during infancy 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, decrease the incidence of total hip arthroplasty in adulthood related to undertreat DDH and prevent avascular necrosis (AVN).

The goal of the treatment is to achieve a concentric reduction of the femoral head into the acetabulum.

Inclusion Criteria:

• Virgin developmental dysplasia of the hip (DDH)
• failed closed reduction in the management of DDH and failed open reduction through medial approach in the management of DDH

Exclusion Criteria:

• cases that managed previously through anterior approach
• old neglected cases above 5 years old children

Operation was done under general anesthesia and patient in supine position. Sterilization was done. Incision was made from anterior half of iliac crest to ASIS (the anterior or anterolateral Smith-Petersen approach with a modified "bikini" incision) .Superficial dissection was done by identify gap between sartorius and tensor fasciae latae, dissect through subcutaneous fat (avoid lateral femoral cutaneous n.), incise fascia on medial side of tensor fascia latae and detach origin of tensor fasciae latae of iliac to develop internervous plane. Deep dissection was done by identify plane between rectus femoris and gluteus medius and detaches rectus femoris from both its origins.