Transverse fractures of the sternum or sacrum each present specific surgical challenges. Here, we report the successful use of a locking compression plate system in a 69-year-old woman with a displaced segmental fracture of the sternum following a motor vehicle accident and a 15-year-old girl with a low transverse fracture of the sacrum (S3-S4) as a result of a snowboarding accident. In both cases, the system provided adequate fixation to allow healing in the 2 fractures, despite the poor bone quality (sternal case) and the thin bone stock (sacral case).