Kocher-Langenbeck posterior approach. A, Skin incision. B, Incision of fascia lata and splitting of gluteus maximus outlined. C, Gluteus maximus has been retracted, exposing short external rotators, sciatic nerve, and superior gluteal vessels. Ascending branch of medial circumflex femoral artery underlies obturator externus and quadratus femoris. D, Hip joint capsule has been exposed by division and posterior reflection of short external rotators. Quadratus femoris and obturator externus are left intact to protect the ascending branch of the medial circumflex artery. E, Osteotomy of greater trochanter and reflection of hamstring origins from ischial tuberosity have enlarged exposure. SEE TECHNIQUE 1.79.