Fig. 7.

Advancing the guide wire, predrilling and screw implantation. a The guide wire is advanced across the sagittal midline in transforaminal sacral fractures. In SI joint disruptions the guidewire should be advanced at least to the extent that the thread (16 or 32 mm) is completely medial of the SI joint in order to obtain a lag screw effect. b Predrilling is performed across the SI joint for a total of three cortices. c A cannulated 6.5 mm fully threaded cancellous screw is inserted over the guide wire as a position screw without compression of the transforaminal sacral fracture