Root and Siegal varus derotational osteotomy of hip. A, Skin incision. B, Incision through gluteus maximus and fascia lata (iliotibial tract). C, Greater trochanter, quadratus femoris, origin of vastus lateralis, tendinous attachment of gluteus maximus, and linea aspera are identified. D, Osteotomy site is exposed in area of lesser trochanter; psoas tendon can be released if necessary. E, Guidewire and chisel are inserted in parallel position. Shaded area represents wedge to be excised; scored line is for reference for later rotation. F, Location of osteotomy planes; proximal osteotomy is 15 mm distal to chisel. G, Rotation is accomplished by external rotation of femur. H, Osteotomy is fixed with AO blade plate, or proximal femoral locking plate. SEE TECHNIQUE 33.4.