A, Multifragmented posterior wall fracture with intraarticular comminution. B, Posterior column fracture with lag screw reaching anterior column. C, Transverse fracture with lag screw reaching anterior column. D, Associated transverse and posterior wall fracture. E, Associated T-type acetabular fracture. Lag screws are inserted into both anterior and posterior columns. F, Anterior column fracture. Several lag screws are placed between inner and outer tables of innominate bone. G, Associated anterior column and posterior hemitransverse fracture. Screws inserted from pelvic brim must reach distal to fracture line and engage in posterior column. H, Both-column fracture operated on through ilioinguinal approach. Screws inserted from pelvic brim reach posterior column. I, Both-column fracture. Internal fixation is performed through extended iliofemoral approach. Two very long screws are inserted into anterior column and reach superior pubic ramus.