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4Anterior column: reduction

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.