Woman, 53 yo. She was hit by a car (pedestrian)
There is juxtatectal transverse fracture with posterior wall fracture. Sacrum fracture => Denis I (left complete) & II (right incomplete). Pubic fracture (Nakatani I right). L5 left transverse process fracture.

Stable hemodynamics.
Comorbid: severe knee osteoarthrosis.

Lateral decubitus position. We've reached the joint through Kocher-Langenbeck approach without trochanter osteotomy. Three plates. Irrigate the entire wound to decrease the risk of periarticular ossification. Insert the suction drain.

Supine position. Next fixation entire sacrum (Denis I & II) by cannulated screw via S1.

Fixed left anterior column acetabulum and right pubic bone (Nakatani I) by locking nails via the three 5 mm stabs (Sklif-style osteosynthesis). Entire operation's time was 270 min. Blood loss was 300 ml. Cell-Saver was not applied.
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