Varus derotational osteotomy (see text) in Legg-Calvé-Perthes disease. A, Level of osteotomy. B and C, Insertion of guide pin. D, Reaming of femur. E, First depth marking flush with lateral cortex. F, Removal of wedge to customize fit. G-I, Plate and compression screw application. J-L, Insertion of bone screws. (Redrawn from Stricker S: Intermediate and pediatric osteotomy systems: technique manual, Memphis, Smith & Nephew Orthopaedics, 2005.) SEE TECHNIQUE 32.2.