It is critical to ensure hip flexion to allow enhanced exposure of the iliac fossa and true pelvis.
The associated both column fractures result from a force applied to the greater trochanter, with medialization of the femoral head. In order to allow manipulation of both the anterior and posterior column fragments, the femoral head must be distracted. This is typically accomplished with the application of lateral and/or longitudinal traction.
The application of traction also provides indirect reduction, particularly of the anterior column.