The patient to the emergency of Shmaisani hospital transferred from Saudia with clinical history of RTA 27-March-2015 with burst fracture of the Th11 and left subtrochanteric fracture. The patient was operated for the pelvic fracture 1 week after the accident. He had fracture right clavicle and the 6 rib right with pneumothorax, for what UWS was applied at the start of the accident.

On examination; the patient is in bed with drop left foot and week left lower limb with analgesia of the left L5 root territory. He has difficulty in urination, for what Foley's catheter was applied.

The patient was sent for investigations and the CXR showed the old fractures and the pelvis showed acceptable alignment of the left femoral head and shaft. The burst fracture was compressing the spinal cord from the left.

Using the C-arm, skeletonization of D10, 11,12 and L1 was achieved. Transpedicular screws Legacy 5.5x40 mm  inserted to D10 and D12. Distraction about 12 mm could reduce the bony part touching the dura of the spinal cord. Another transpedicular screws LEGACY MA 5.5x45 mm inserted to L1. 2 rods bended slightly to adopt the natural curve of the area 130 mm were used and fixation of D10-12 and L1 was achieved after applying the maximal distraction both sides. The C-arm showed acceptable alignment, that there was no need to perform laminectomy or to explore the dura around the previously compressed area. Cross connector 22 applied. Routine closure of the wound.

Smooth postoperative recovery. The power of the left leg became slightly better than before the surgery.

The patient has unacceptable fracture of the 11 dorsal body. fixation with decompression was indicated even after 45 days of delay. The patient was prepared for all scenarios, but distraction of D10-12 achieved remote the desired result, for what fixation with distraction were limited in this procedure.