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4Anterior column: reduction

Reduction of the iliac wing

The first step involves reduction of the iliac wing to the intact ilium (portion of the ilium that remains normally associated with the sacrum).

Start reduction from the proximal aspect of the iliac wing. Reduce accessory fragments of the iliac wing, if present.

Reduction must be perfect, without any small step-offs, gaps, or angulation. Check the outer aspect of the iliac crest.

It is important to restore the normal curvature of the iliac wing, and not to straighten it excessively.

Pointed reduction forceps applied to the iliac crest can serve as handles for reduction, and also for temporary fixation.

Alternatively, apply a Farabeuf clamp over screws placed into the crest on each side of a fracture line.