Iliac fixation for spinal constructs has been utilized since the initial description of the Galveston technique by Allen and Ferguson in 1982 . Utilization in trauma constructs has also been well described for a variety of injury patterns including lumbopelvic dislocations and fracture dislocations , sacral fractures , and low lumbar burst fractures . The key indication for placement of an iliac screw for trauma is the identification of the need for an additional point of fixation in order to assure postoperative stability. This may necessitate two screws placed ipsilaterally for rotational stability as one screw, particularly if smaller in diameter, may toggle and loosen during early weight bearing . Complications of iliac screw placement for trauma involve late pain from implant prominence and wound complications related to the dissection .