Plate fixation of the anterior column
The cranial most screws are placed parallel to the SI joint, anchoring the plate to the sciatic buttress. This provides assistance with the reduction (as previously described) as well as definitive buttress stabilization of the anterior column.
Screws can be placed through the plate into the reduced anterior column fragment, depending on the fracture morphology.
At this point, it is critical to ensure that no screws cross into the posterior column fracture or fragment. This would block the reduction of the posterior column fragments.