Fig. 3From: Trans-sacral screw fixation of posterior pelvic ring injuries: review and expert opinionIllustration of a vertical sacral fracture with both iliosacral screw fixation and trans-sacral screw fixation. During loading on the ipsilateral side, the force vector is directed cranially. This force is distributed along a longer implant length in the trans-sacral screw versus the iliosacral screw. Further, the contralateral iliac cortex has higher bone density than the S1 bodyBack to article page