Mears and Rubash triradiate extensile approach. A, Skin incision. B, Superficial fascial incision. C, Origin of tensor fasciae latae has been elevated from anterior iliac crest. Gluteus maximus has been split in line with its fibers up to inferior gluteal nerve and vessels. D, Greater trochanter has been osteotomized and reflected posteriorly exposing sciatic nerve and short external rotators. Gluteal and tensor fasciae latae muscles have been elevated from outer table of ilium and hip joint capsule and reflected posteriorly. E, Short external rotators have been severed from greater trochanter and reflected posteriorly. Quadratus femoris remains intact. Gluteal and tensor fasciae latae muscles have been retracted superiorly and held with Steinmann pins to expose posterior column. Joint capsule has been severed circumferentially from acetabulum. F, Abdominal muscles have been incised and iliacus muscle elevated subperiosteally from ilium and reflected medially to expose inner table of ilium (see text and also TECHNIQUE 1.83.