Iliac and lumbosacral fixation with sacral-alar-iliac screws. A, Starting point for screw insertion. B, Screw trajectory. C and D, Fluoroscopic confirmation of appropriate trajectory. E, With proper trajectory, iliac teardrop should be visible on anteroposterior image. F, Path of probe or drill within 20 mm of the greater sciatic notch and aimed toward the anterior inferior iliac spine. G, Guidewire placed through drilled hole. H-J, Fluoroscopic teardrop view to confirm screw placement. K, Final position of rods. SEE TECHNIQUE 44.34.