Background: Vertical shear open pelvic fractures are severe, unstable injuries that often require definitive posterior stabilization beyond external fixation. We report a case of a 20-year-old male, two months after a road traffic accident, presenting with bilateral pubic rami fractures, superior displacement of the right hemipelvis. Femoral traction-assisted reduction was performed using a temporary external fixation construct by connecting iliac Schanz pins to a distal femoral traction pin to apply controlled axial traction, followed by percutaneous S1 and S2 iliosacral screw fixation under fluoroscopic guidance. At three months, the patient was pain-free, walking independently, and showed minimal limb shortening, demonstrating that femoral traction-assisted reduction with percutaneous screw fixation is a minimally invasive and effective approach for neglected vertical shear pelvic fractures.

Keywords: External fixation, Femoral traction-assisted reduction, Neglected open pelvic fracture, Vertical shear pelvic fracture