INDICATIONS: Quadrilateral surface combination associated with acetabular fracture, Sacrum Fracture, Posterior Iliac Fracture APPROACH: • The standard horizontal approach to the symphysis is used for reduction and fixation of the Pubis and medial Ramus fractures. • For more lateral exposure of the pubic Ramus, a lateral extension of the standard approach or a modified Stoppa incision may be necessary. • For access to an unstable iliac wing fracture, or the anterior part of the SI joint, including suitable crescent fractures, the anterior approach to the iliac wing is necessary.