Vertically unstable pelvic ring injuries associated with comminuted transforaminal sacral fractures present a special problem to the treating surgeon in applying stable fixation for maintaining reduction. Triangular osteosynthesis and spinal-pelvic constructs are relatively new techniques used to avoid loss of reduction for treating these difficult fractures, and the last decade has seen a marked increase in the use of these techniques. This article aims to describe the indications and technical aspects in the use of spinal-pelvic constructs for vertical shear sacral fractures such that they can be applied to better help the patients with these injuries.