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6Anterior column: reduction and fixation

After provisional or even definitive fixation of the cranial anterior column, it is possible to adjust the distal anterior column reduction (green arrows). Thus, final alignment and periarticular fixation are the essential final steps of anterior column reduction and fixation.

Multiple clamps can aid in this final reduction. A point to point Weber clamp applied to the anterior column at the interspinous notch to the newly reconstructed ilium can achieve excellent compression and maintain provisional reduction of the anterior column. Commonly, one must augment this reduction maneuver with a Schanz screw or additional adjuncts.

Alternatively, a two-screw technique utilizing a Farabeuf or Jungbluth clamp can effectively derotate the anterior column while compressing its fracture line to the reconstructed ilium.