Once the periacetabular fracture is controlled reduction of the iliac wing to the intact ilium (portion of the ilium that remains normally associated with the sacrum) can begin if required.
High fractures will be adequately controlled by the fixation at the pelvic brim. It may be necessary to supplement this with the addition of a lateral window.
With an approach through a small lateral window, direct reduction and screw or plate fixation can be completed.
Start reduction from the proximal aspect of the iliac wing. Reduce accessory fragments of the iliac wing, if present.
It is important to restore the normal curvature of the iliac wing, and not to straighten it excessively.
Pointed reduction forceps applied to the iliac crest can serve as handles for reduction, and also for temporary fixation.
Alternatively, apply a Farabeuf clamp over screws placed into the crest on each side of a fracture line.