Pelvic brim fragment
Very commonly, there is a large separate fragment of bone just above the point that the anterior column fracture crosses the pelvic brim. This fragment must be reduced anatomically to allow a read of the anterior column reduction.
Manipulation with a dental pick and pressure with a ball spike pusher are helpful.
Once successfully reduced, provisional fixation with a K-wire may be useful. If the fragment is large enough, a 2.4 mm or a 3.5 mm screw can secure this fragment.