Background: Acetabular anterior column fractures are challenging to manage due to the complex anatomy and limited surgical corridors. While retrograde screw fixation is commonly used, it often poses technical difficulties. We report a case of a 32-year-old female with an anterior column acetabular fracture, treated with percutaneous antegrade anterior column screw fixation using a retrograde guidewire entry. The technique facilitated accurate screw placement, minimized intraoperative difficulties, and allowed for early postoperative mobilization with favorable radiological and functional outcomes. This hybrid technique may represent a practical alternative for anterior column fixation by combining the accuracy of retrograde guidewire placement with the biomechanical advantages of antegrade screw fixation.

Keywords: Anterior column, Antegrade, Retrograde