Fig. 3

A longitudinal incision was made directly anterior to the distal right thigh, enabling the release and V-Y lengthening of the quadriceps muscle (A). Following quadriceps lengthening, the right knee achieved passive flexion of 90° (B). The right knee joint was repositioned with the proximal tibia in good alignment with the distal femur, and the right lower limb was immobilized in a tubular cast after flexion of the knee at 83°. (C); Removal of the cast at five weeks postoperatively, with the right knee flexed close to 90°, in closed resurfacing of bilateral developmental hip dislocation (D); Increase the angle of flexion of the right knee by approximately 20° and continue cast immobilization. (E)