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Sacral plate fixation is recommended.

Posterior sacral laminectomy with decompression of the sacral nerve roots, open reduction, and stable internal fixation is recommended.

If comminution is significant, interfragmentary compression should be performed with caution, if at all.

Following posterior plate fixation, it will be necessary to add anterior stabilization, with reduction if required. This is necessary to protect the posterior sacral tension band, which is the mechanical function of the typical posterior sacral plates.