After the exposure has been completed, the first step in the reconstruction involves the reduction and fixation of the SI joint fracture dislocation.
The intact segment of the ilium (1 - that which has maintained its normal relationship with the sacrum) acts as the cornerstone for the reduction. The intercalary fragment of the SI joint/sciatic buttress (2) is reduced to the intact iliac segment. This is commonly accomplished with a two-screw technique utilizing a Farabeuf or Jungbluth clamp. The read of the fracture reduction on the outer ilium guides the reduction. Reaching though the sciatic notch, one can palpate the internal reduction of the SI joint, which will occur as this fragment is reduced.