Corticotomy (Paley). A, Skin incision of 1.5 cm with periosteal elevation. B, Osteotome is twisted transversely to cut groove in anterior cortex only. C, Anterior groove is cut to, but not through, medullary cavity. D, Periosteum is elevated laterally, and lateral cortex is cut with 5-mm osteotome to and through posterolateral corner. E, Anteromedial periosteum is elevated, and medial cortex is cut. F, Osteotome is twisted 90 degrees in posteromedial cortex to crack it and is inserted in posterolateral cortex and twisted. G, Osteoclasis is completed by gentle controlled external rotation of fixator rings.