Fig. 2.

Initial left hip sonogram of a female patient at six months of age who showed a Graf type IIIb hip (a:40°, b:100°) (a). A Pavlik harness was initially used but the treatment was considered to fail within four weeks. Anteroposterior pelvic radiograph of the same patient at seven months of age (b) showed that the left hip was still dislocated, so an immediate closed/open reduction and casting was planned. Intraoperative arthrogram of the same patient (c) following iliopsoas and adductor tenotomies through the posteromedial approach showed that the labrum was inverted, transverse acetabular ligament was hypertrophied and there was still medial pooling of the dye due to hypertrophied ligamentum teres. An open reduction was performed to obtain a concentric reduction.