Derotation, alignment and reduction of the anterior column
The reduction of the anterior column (4) takes multiple adjuncts. Hip flexion can relax the pull of the rectus and greatly assist at this stage in the surgery.
The anterior column should be derotated with help of a Farabeuf clamp and/or a Schanz screw applied to the anterior innominate bone.
The iliac crest portion of the fracture can be manipulated and the reduction maintained with the help of pointed reduction forceps.