Abnormal Femoral anteversion in CDH cases is common and may be extreme. This makes uncemented total hip replacement difficult. If maximum metaphyseal fill is achieved, the prosthesis ends up too anteverted. Insertion in correct version means poor metaphyseal fill. Use of a fixation sleeve eliminates this problem. The sleeve is inserted for maximum fill and the stem is locked into the sleeve in the appropriate version. Maximum fit can therefore be achieved