Sequence of the treatment
ilioinguinal approach the sequence of reduction of the associated both column fractures begins with reduction of the iliac wing (1) to the intact ilium. The high and mid portions of the anterior column (2) are then reduced and stabilized. The posterior column (3) is then reduced to the anterior column. If there is low anterior column involvement (4), this is subsequently reduced.
If there is an associated posterior wall component, it is most commonly reduced after the posterior column reduction. Occasionally, in the case of very large posterior wall fragments, one may need to reduce the posterior wall prior to the posterior column.
The peripheral reduction must be anatomical, since displacement there will aggravate malreduction at the acetabular fossa.
In cases with marginal impaction, elevation and bone grafting is an indispensable part of the procedure.