Aims. The aims of this study were to assess the pre- and postoperative incidence of deep vein thrombosis (DVT) using routine duplex Doppler ultrasound (DUS), to assess the incidence of pulmonary embolism (PE) using CT angiography, and to identify the factors that predict postoperative DVT in patients with a pelvic and/or acetabular fracture. Methods. All patients treated surgically for a pelvic and/or acetabular fracture between October 2016 and January 2020 were enrolled into this prospective single-centre study. The demographic, medical, and surgical details of the patients were recorded. DVT screening of the lower limbs was routinely performed using DUS before and at six to ten days after surgery. CT angiography was used in patients who were suspected of having PE. Age-adjusted univariate and stepwise multiple logistic regression analysis were used to determine the association between explanatory variables and postoperative DVT. Results. A total of 191 patients were included. A DVT was found preoperatively in 12 patients (6.3%), of which six were proximal. A postoperative DVT was found in 42 patients (22%), of which 27 were proximal. Eight patients (4.2%) had a PE, which was secondary to a DVT in three. None of the 12 patients in whom a vena cava filter was implanted prophylactically had a PE. Multivariate logistic regression analysis indicated that the association with the need for spinal surgery (odds ratio (OR) 19.78 (95% confidence interval (CI) 1.12 to 348.08); p = 0.041), intramedullary nailing of a long bone fracture (OR 4.44 (95% CI 1.05 to 18.86); p = 0.043), an operating time > two hours (OR 3.28 (95% CI 1.09 to 9.88); p = 0.035), and additional trauma surgery (OR 3.1 (95% CI 1.03 to 9.45); p = 0.045) were statistically the most relevant independent predictors of a postoperative DVT. Conclusion. The acknowledgement of the risk factors for the development of a DVT and their weight is crucial to set a threshold for the index of suspicion for this diagnosis by medical staff. We suggest the routine use of the DUS screening for DVT in patients with a pelvic and/or acetabular fracture before and six to ten days after surgery. Cite this article: Bone Joint J 2022;104-B(2):283–289

Aims. The anterior pelvic internal fixator is increasingly used for the treatment of unstable, or displaced, injuries of the anterior pelvic ring. The evidence for its use, however, is limited. The aim of this paper is to describe the indications for its use, how it is applied and its complications. Patients and Methods. We reviewed the case notes and radiographs of 50 patients treated with an anterior pelvic internal fixator between April 2010 and December 2015 at a major trauma centre in the United Kingdom. The median follow-up time was 38 months (interquartile range 24 to 51). Results. Three patients were excluded from the analysis leaving 47 patients with complete follow-up data. Of the 47 patients, 46 achieved radiological union and one progressed to an asymptomatic nonunion. Of the remaining patients, 45 required supplementary posterior fixation with percutaneous iliosacral screws, 2 of which required sacral plating. The incidence of injury to the lateral femoral cutaneous nerve (LFCN) was 34%. The rate of infection was 2%. There were no other significant complications. Without this treatment, 44 patients (94%) would have needed unilateral or bilateral open reduction and plate fixation extending laterally to the hip joint. Conclusion. The anterior pelvic internal fixator reduces the need for extensive open surgery and is a useful addition to the armamentarium for the treatment of anterior pelvic injuries. It is associated with injury to the LFCN in a third of patients. Cite this article: Bone Joint J 2017;99-B.1232–6

We describe our early operative experience with a new pelvic reduction frame and the standard of reduction of fractures of the pelvic ring which we achieved in the first 35 consecutive patients, with 34 acute fractures and one nonunion. The pre-operative and immediate post-operative radiographs were measured, using two methods, to find the maximum radiological displacement of the fracture and the quality of the reduction according to the criteria of Tornetta and Matta. There were 19 vertical shear fractures and 16 compression injuries. The mean age of the patients was 33.5 years (10 to 59) and mean delay to surgery was 4.6 days (0 to 16) in the 34 acute injuries. The mean operative time in isolated procedures was 103.4 minutes (. sd. 6.5). All but one patient had iliosacral screws implanted, 18 had screws in the anterior column, six had plates at the symphysis pubis and 12 had anterior external fixators. The mean maximum horizontal or vertical displacement was improved from 30.8 mm (. sd. 2.7) to a mean of 7.1 mm (. sd. 0.7). The reduction was assessed as excellent in ten patients, good in 18, and fair in the remainder. There was no significant influence on the quality of the reduction caused by obesity (p = 0.34), the type of fracture (p = 0.41) or delay to surgery (p = 0.83). The frame was shown to be effective, allowing the surgeon to obtain a satisfactory reduction and fixation of acute displaced disruptions of the pelvic ring

A common injury pattern in current military experience is traumatic lower limb amputation from improvised explosive devices. This injury can coexist with pelvic girdle fractures. Of 67 consecutive patients with traumatic lower limb amputations treated in Camp Bastion Hospital Afghanistan, 16 (24%) had an associated pelvic fracture (10 APC/vertical shear and 6 acetabular or pubic rami fractures). Traumatic single amputees (n=28) had a 14% incidence of associated pelvic fracture with traumatic double amputees (n=39) increasing this association to 31%. However if the double amputations were above knee the incidence of associated open book fractures was 26% (6/23) with 39% (9/23) sustaining some form of pelvic bony injury. The majority of patients (95%) had a pelvic X-ray as part of the primary survey. Of these 51% (n=34) had a Sam sling(r) in situ but only fifteen were deemed appropriately applied. Given the high risk of pelvic fractures in patients with traumatic bilateral lower limb amputations, particularly those involving opening of the pelvic ring, it is imperative that the earliest and proper application of a pelvic binder be initiated

Aims. A high rate of suicide has been reported in patients who sustain fractures, but the association remains uncertain in the context of other factors. The aim of this study was to examine the association between fractures and the risk of suicide in this contextual setting. Patients and Methods. We performed a case-control study of patients aged 40 years or older who died by suicide between 2000 and 2011. We included patients’ demographics, physical and mental health problems, and socioeconomic factors. We performed conditional logistic regression to evaluate the associations between fractures and the risk of suicide. Results. We included a total of 34 794 patients who died by suicide and 139 176 control patients. We found that fractures as a homogenous group (adjusted odds ratios (aOR), 1.48; 95% confidence interval (CI) 1.43 to 1.53), and specifically pelvic (aOR 2.04; 95% CI 1.68 to 2.47) and spinal fractures (aOR 1.53; 95% CI 1.43 to 1.64), were associated with a higher risk of suicide. In addition, we found that patients who had a lower income, had never married, had lower levels of educational attainment, or had coexistent physical and mental conditions such as anxiety, mood disorders, and psychosis-related disorders had a higher risk of suicide. Conclusion. Fractures, specifically those of the hip and spine, were associated with an increased risk of suicide. The findings suggest that greater clinical attention should be given to this risk in patients with fractures, especially for those with additional risk factors. Cite this article: Bone Joint J 2018;100-B:780–6

Aim. There is not adequate evidence to establish whether external fixation (EF) of pelvic fractures leads to a reduced mortality. We used the Japan Trauma Data Bank database to identify isolated unstable pelvic ring fractures to exclude the possibility of blood loss from other injuries, and analyzed the effectiveness of EF on mortality in this group of patients. Patients and Methods. This was a registry-based comparison of 1163 patients who had been treated for an isolated unstable pelvic ring fracture with (386 patients) or without (777 patients) EF. An isolated pelvic ring fracture was defined by an Abbreviated Injury Score (AIS) for other injuries of < 3. An unstable pelvic ring fracture was defined as having an AIS ≥ 4. The primary outcome of this study was mortality. A subgroup analysis was carried out for patients who required blood transfusion within 24 hours of arrival in the Emergency Department and those who had massive blood loss (AIS code: 852610.5). Propensity-score matching was used to identify a cohort like the EF and non-EF groups. Results. With the use of propensity-score matching using the completed data, 346 patients were matched. When the propensity-score matching was adjusted, EF was associated with a significantly lower risk of death (p = 0.047). In the subgroup analysis of patients who needed blood transfusion within 24 hours and those who had massive blood loss, EF was associated with a significantly lower risk of death in patients who needed blood transfusion within 24 hours (p = 0.014) and in those with massive blood loss (p = 0.016). Conclusion. The use of EF to treat unstable pelvic ring fractures was associated with a significantly lower risk of death, especially in patients with severe fractures. Cite this article: Bone Joint J 2018;100-B:233–41

Aims. This study aimed to analyze the correlation between transverse process (TP) fractures of the fourth (L4) and fifth (L5) lumbar vertebrae and biomechanical and haemodynamic stability in patients with a pelvic ring injury, since previous data are inconsistent. Patients and Methods. The study is a retrospective matched-pair analysis of patients with a pelvic fracture according to the modified Tile AO Müller and the Young and Burgess classification who presented to a level 1 trauma centre between January 2005 and December 2014. Results. A total of 728 patients with pelvic ring injuries were included, of whom 183 (25.1%) had a biomechanically unstable pelvic fracture. Of these patients, 84 (45.9%) had a fracture of a TP of L4 and/or L5. A total of 73 patients (13.4%) with a stable pelvic ring injury (p < 0.001) had a fracture of a TP. Patients with a fracture of a TP of L4 and/or L5 had a 5.5-fold risk (odds ratio (OR)) of having a biomechanically unstable pelvic injury. TP fractures (OR 1.6, p = 0.2) could not be confirmed as an independent predictor of haemodynamic instability. Conclusion. This is the first study that has demonstrated a positive correlation between a TP fracture of L4 and/or L5 and a biomechanically unstable pelvic ring injury. The presence of transverse process fractures of L4 and/or L5 indicates increased severity of pelvic injury and therefore can help in the planning of emergency treatment. Cite this article: Bone Joint J 2018;100-B:1214–19

Purpose of study. To review the treatment and outcomes of paediatric pelvic ring injuries in the UK. Methods and results. We performed a retrospective review of all pelvic fracture admissions to an English paediatric major trauma centre (MTC) from 2012 to 2016. A total of 29 patients were admitted with pelvic ring injuries with a mean age of 11 years (4- 16yrs). Road traffic accident was the mechanism in majority (72%), followed by fall from height (24%). Femoral shaft fracture was present in 5 (17%), head injury in 5 (17%), chest injuries in 5 (17%) and bladder injury in one child. 48% patients needed surgical procedures for fractures or associated injuries. We differentiated injuries according to the classification system of Torode and Zeig. 17% were Type A, 3% Type B, 48% Type C and 31% Type D. Almost all (93%) patients were treated conservatively. 51% of patients were allowed to mobilize full weight bearing after a period of bed rest. Non-weight bearing mobilization was recommended for fractures extending into the acetabulum, sacral fractures, unstable fracture patterns or associated fractures (neck of femur, femoral shaft and tibial shaft). Surgical fixation occurred in two patients. Both of these patients had significantly displaced Type D fractures. Only 44% of patients were back to sports at six months. Conclusions. Pelvic ring injuries are rare within the paediatric population and are associated with a high incidence of concomitant injury and significant functional morbidity. Their treatment should involve a multidisciplinary approach, which includes specialist in the care of pelvic trauma

We performed a systematic review of the literature to evaluate the use and interpretation of generic and disease-specific functional outcome instruments in the reporting of outcome after the surgical treatment of disruptions of the pelvic ring. A total of 28 papers met our inclusion criteria, with eight reporting only generic outcome instruments, 13 reporting only pelvis-specific outcome instruments, and six reporting both. The Short-Form 36 (SF-36) was by far the most commonly used generic outcome instrument, used in 12 papers, with widely variable reporting of scores. The pelvis-specific outcome instruments were used in 19 studies; the Majeed score in ten, Iowa pelvic score in six, Hannover pelvic score in two and the Orlando pelvic score in one. Four sets of authors, all testing construct validity based on correlation with the SF-36, performed psychometric testing of three pelvis-specific instruments (Majeed, IPS and Orlando scores). No testing of responsiveness, content validity, criterion validity, internal consistency or reproducibility was performed. The existing literature in this area is inadequate to inform surgeons or patients in a meaningful way about the functional outcomes of these fractures after fixation

INTRODUCTION. Limb salvage surgery is a common treatment for patients who suffer from bone tumors. In the case of pelvic tumors this creates a challenge for the surgeon and the treatment remains controversial because the oncologic complications like local recurrence, dissemination and orthopaedic ones, like infection, haemorrhage, and mechanical problems of reconstructions Tumors affecting the acetabulum are a challenge for the surgeon because of the impact in the function of the extremity. There are many reconstruction techniques described in the literature like prosthesis, allograft systems, arthrodesis, etc…, but still there is not a gold standard due to the poor functional results at long term follow up, and the associated complications of all techniques. In this study we show the experience in our center on pelvic reconstructions after tumors affecting the acetabulum area (zone II). MATERIAL AND METHODS. We surgically treated 81 pelvic tumors from 1997 to 2009 following the Enneking and Dunham calssification attending to the localization of the tumor: Zone I 38 (iliac bone)Zone II 25 (acetabulum)Zone III 18 (pelvic branches)In zone II tumors we performed pelvic reconstruction in eight cases, with different type of prosthesis. In 5 cases we performed saddle prosthesis (group A) and in 3 cases we performed Coned-Stanmore Implants type prosthesis with sacro-iliac anchorage. The mean follow up of the serie was 3,5 years (1–6 years). In group A the mean follow up was 5 years and in group A and in group B the mean follow up was 1 year due to the recent implantation in our center of Coned type prosthesis for pelvic reconstruction. We evaluated our results with these two types of prosthesis. RESULTS. Oncologic: group A we had a local recurrence of 25% and 25% of the patients died. group B we had no cases of local or systemic recurrence and we didn't registered any death. Functional: In group A the patients showed local pain and difficulty to walk probably due to the change of the center of rotation of the hip and instability of the saddle prosthesis. In group B all patient's followed physical therapy programs without problems and were able to walk with crutches ten months after surgery. Complications:group A we had a 25% of perioperative infection and a 25% of dislocation of the prosthesis. In group B we did not have any of these complications. CONCLUSIONS. Saddle prosthesis mantain the length of the extremity and allow weight bearing but they do not give a good stability. Even if we only have one year follow up with this Coned prosthesis with sacro iliac anchorage we achieved much better functional results and a lower rate of complications

We prospectively studied the outcome of a protocol of prophylaxis for deep vein thrombosis (DVT) in 103 consecutive patients undergoing surgical stabilisation of pelvic and acetabular fractures. Low-molecular-weight heparin (LMWH) was administered within 24 hours of injury or on achieving haemodynamic stability. Patients were screened for proximal DVT by duplex ultrasonography performed ten to 14 days after surgery. The incidence of proximal DVT was 10% and of pulmonary embolus 5%. Proximal DVT developed in two of 64 patients (3%) who had received LMWH within 24 hours of injury, but in eight of 36 patients (22%) who received LMWH more than 24 hours after the injury (p < 0.01). We conclude that LMWH, when begun without delay, is a safe and effective method of thromboprophylaxis in high-risk patients with major pelvic or acetabular fractures

We have evaluated retrospectively the relationship of bony injuries seen on 106 consecutive MR scans in elderly patients of a mean age of 81.4 years (67 to 101) who were unable to bear weight after a low-energy injury. There were no visible fractures on plain radiographs of the hip but eight patients (7.5%) had fractures of the pubic ramus. In 43 patients (40.5%) MRI revealed a fracture of the femoral neck and in 26 (24.5%) there was a fracture of a pubic ramus. In 17 patients (16%) MRI showed an occult sacral fracture and all of these had a fracture of the pubic ramus. No patient with a fracture of the femoral neck had an associated fracture of the pelvic ring or vice versa. Occult fracture of the hip and of the pelvic ring appear to be mutually exclusive and if an acute fracture of the pubic ramus is diagnosed radiologically further investigations are not needed to rule out an occult fracture of the hip

The purpose of this study was to assess the stability of a developmental pelvic reconstruction system which extends the concept of triangular osteosynthesis with fixation anterior to the lumbosacral pivot point. An unstable Tile type-C fracture, associated with a sacral transforaminal fracture, was created in synthetic pelves. The new concept was compared with three other constructs, including bilateral iliosacral screws, a tension band plate and a combined plate with screws. The pubic symphysis was plated in all cases. The pelvic ring was loaded to simulate single-stance posture in a cyclical manner until failure, defined as a displacement of 2 mm or 2°. The screws were the weakest construct, failing with a load of 50 N after 400 cycles, with maximal translation in the craniocaudal axis of 12 mm. A tension band plate resisted greater load but failure occurred at 100 N, with maximal rotational displacement around the mediolateral axis of 2.3°. The combination of a plate and screws led to an improvement in stability at the 100 N load level, but rotational failure still occurred around the mediolateral axis. The pelvic reconstruction system was the most stable construct, with a maximal displacement of 2.1° of rotation around the mediolateral axis at a load of 500 N

Objective. We reviewed clinical results with minimally invasive method and using a new developed plate for unstable pelvic ring fractures, especially vertically unstable sacral fractures. Materials & Methods. Between 2002 and 2010, 35 patients with vertically unstable sacral fractures were treated with minimally invasive method and using an M-Shaped transiliac plate which was developed by the author. This plate is anatomically designed for posterior pelvic ring, and achieved rigid fixation. Patients included 19 male and 16 female, with the mean age of 46.2 (range, 17∼79) years old. According to the AO classification, 23 patients had a C1 injury, 9 had a C2 fracture, and 3 patients sustained a C3 injury of the pelvic ring. Functional outcome was assessed using the Majeed's functional evaluation and radiography. Minimum follow-up was one year. Results. All patients were not fixed anterior of pelvic ring. The average of surgical time was 85 minutes (range: 45∼150), and intraoperative blood loss was 332.8 ml (range: 35∼1055). Postoperative functional results were excellent and good in 30 patients (85.7 %), and fair in four cases due to infection or sciatic nerve paralysis, and one case of poor was nonunion. Three patients complicated wound healing delayed, but there were no residual pain and re-displacement. Conclusion. Using an M-Shaped transiliac plate can be achieved significant outcome and rigid fixation with minimal invasion for vertically unstable sacral fractures

Aim. Evaluate the outcome and complications of anterior pubic symphysis plating in the stabilisation of traumatic anterior pelvic ring injuries. Methods. All patients who underwent pubic symphysis plating in a tertiary referral unit were studied. Fracture classification, type of fixation, complications, and incidence of metalwork failure were recorded. Results. Out of 178 consecutive patients, 159 (89%) were studied for a mean of 41 months. There were 121 males and 38 females (mean age 38 years). Symphysis pubic fixation was performed in 105 AO-OTA type B and 54 type C injuries using a Matta symphyseal plate (n = 92), reconstruction plate (n = 65), or DCP (n = 2). Supplementary posterior pelvic fixation was performed in 103 patients. 6 patients required revision for failure of fixation or symptomatic instability of the pubic symphysis. A further 7 patients had metalwork removed for other reasons. Metalwork breakage occurred in 66 patients (42%), at a mean of 17 months. 64 of these 66 patients were asymptomatic and metalwork was left in situ. Conclusions. Plate fixation of the symphysis pubis is an effective method of stabilising anterior pelvic ring injuries with a low complication rate. There is a high rate of late metalwork breakage, but this is not clinically significant

Background. Ilizarov hip reconstruction is a salvage option traditionally done with fixators, which often face limited compliance. We aimed at reviewing our early results of a novel technique with internal devices. Material and Methods. Retrospective evaluation of 7 patients was done that underwent Milch Batchelor procedure with dual plates followed by a second stage femoral lengthening by retrograde magnetic nail. The mean patient age was 13.8 years. A mean valgus of 410 (range, 300 to 550) and extension of 220 (range, 100 to 300) were created proximally. Results. At their mean recent follow-up of 19 months, all extremities were aligned with a mean Pelvic Mechanical Axis Angle (PMAA) of 83.80 and lateral Mechanical Axis Deviation (MAD) of 25.3 mm. The mean Lower-extremity Length Discrepancy (LLD) improved from 3.7 cm (range, 3 to 5 cm) preoperatively to 0.7 cm (range, 0 to 2 cm). The Trendelenburg sign was eliminated in five and delayed in 2. According to a predesigned clinical scoring system, there were 3 (43%) excellent, 2 (28.5%) good, 2 (28.5%) fair, and no poor results. One patient at 9 weeks broke plates, however went for healing. Conclusion. PSHR with internal devices is a patient-friendly alternative to fixators

We present the results of Chiari pelvic osteotomy in the treatment of adolescent hip incongruence, with special interest in identifying possibilities, limitations and complications. In a series of 86 patients treated by Chiari pelvic osteotomy (13 operated bilateraly) at the Institute for Orthopaedic Surgery “Banjica” with a follow-up period more than 48 months, we analyzed the relation of Chiari-specific parameters collected from postoperative radiograms (osteotomy angle and heigth, and displacement index) to various preoperative and postoperative parameters (Sharp acetabular angle, Wiberg CE angle, Heyman and Herndon femoral head extrusion index (FHEI), Acetabular depth ratio (ADR), Shenton-Menard arch integrity, limb length discrepancy, gait quality) and functional result according to HHS and McKay scoring systems. We found highly significant improvements of Sharp angle (from 47.2±6.1° preoperatively to 38.6±7.8° finally, p<0.01), Wiberg CE angle (from 10.2±16.8° to 38.9±14.6°, p<0.01) and FHEI (from from 53.4±21% to 1.9±70.7%, p<0.01). In adition, HHS was also improved from 76±15.1 to final 87.9±9.4, p<0.01). We also assessed the satisfaction of both patients (index 4.2 out of 5) and surgeons (index 3.7 out of 5). Chiari pelvic osteotomy is useful surgical procedure in the selected cases of adolescent hip incongruence with disturbance of hip centering and coverage

Sacroiliac screw fixation is the method of choice for the definitive treatment of unstable posterior pelvic ring injuries; however this technique is demanding and associated with a high risk of iatrogenic neurovascular damage. We therefore evaluated the outcome, complications, surgical and fluoroscopy time for unstable posterior pelvic ring injuries managed with a transiliac locked compression plate. 23 patients were managed with a transiliac locked compression plate for unstable posterior pelvic injuries at a Level I Trauma Center. 21 patients were available for follow up after an average of 30 months and outcome evaluation was performed with the Pelvic Outcome Score, which is composed of a clinical, radiological, and social integration part. The overall outcome for the pelvic outcome score was excellent in 47.6% (10 patients), good in 19% (4 patients), fair in 28.6% (6 patients) and poor in 4.8% (1 patient). 15 out of 21 patients (71.4%) returned to their normal life, 3 patients (14.3%) were limited at work, and 3 patients (14.3%) were not able to return to work due to their disabilities. The social status was unchanged to the preinjury status in 19 patients (90.5%). 13 patients (62%) stated no changes in spare time and sports activities; 4 patients (19%) had minor and another 4 patients (19%) had major restrictions. The average operation time was 101 min and intraoperative fluoroscopic time averaged 74.2 sec. No iatrogenic neurovascular injuries were observed. Posterior percutaneous plate osteosynthesis may be a good alternative to sacral screw fixation because it is quick, safe, and associated with a good functional outcome

Objectives. The additive use of an external modular device may improve dorsal compression forces in pelvic external fixation. This would improve the efficiency of indirect reduction and stabilization with an anterior pelvic external fixator. The purpose of this study was to determine the forces of the posterior pelvis achieved by a new device improving the application of a supraacetabular anterior external fixator compared with other constructs. Material and Method. Synthetic pelvic models were used. Complete pelvic ring instability was created by symphyseal and unilateral sacroiliac joint disruption. Four different constructs of fixation were tested. A pressure-sensitive film was placed in the sacroiliac joint. The constructs were applied in a standardized way. The maximum sacroiliacal compression loads (N) of each trial was recorded. Statistics was performed with the student t-test. Results. Standard supraacetabular two-pin external fixator achieved a dorsal compression load of 13.84 (SD 8.13). The new dorsal pelvic compression device delivered 177.05N (SD 32.32) of load across the sacroiliac joint when the pins were inserted half way and 183.58N (SD 46.64) with full pin insertion. Both the half- and full-pin construct demonstrated a significant dorsal load improvement with the pelvic compressor (p<0.05) compared with the standard supraacetabular fixator group. The C-clamp revealed compression forces of 384.88N (SD 22.95), which was significantly greater than all the other groups (p<0.05). Conclusion. We tested a simple and new modular device for improved application of pelvic external fixation. The centres of rotation of supra-acetabular pins were determined and used to achieve greater dorsal compression forces in disrupted pelvic ring injuries. The compression load is less than with a C-Clamp, but significantly greater than the familiar technique of standard external supra-acetabular fixation. This improves the initial stability in acute management of unstable, disrupted and life threatening pelvic ring fractures

Introduction. The clinical and functional outcome following simultaneous fractures of the acetabulum and pelvic ring represent a challenge for the clinician and are currently obscure in the existing literature. Patients and Methods. Between January 2003 and July 2009 all patients with combined pelvic and acetabular fractures were included in this prospectively study. Demographic details, mechanism of injury, ISS, surgical procedures, post-operative course, length of hospital stay, and radiological (Matta's score) and functional outcomes (The Merle d' Aubigne hip score) were recorded. The minimum follow up was 12 months (12–72). Results. Out of 520 cases, 30 (21 males) patients met the inclusion criteria. The mean age was 32. 55% sustained lateral compression, 40% combined mechanism and 5% anterior/posterior type of injury pattern. 15 out of the 30 patients had sustained other injuries. The mean time from injury to definite reconstruction was 7 days (3–14). Ilioinguinal approach was used in 20 patients, Pfannestiel in 2 and Kocher-Langebeck in 4. A wheelchair was used initially in 22 cases. The median time to FWB was 3 months. One patient underwent a THR at 18 months. 19 patients scored the full 18 points of the Merle score. Matta radiological score was excellent in 16 patients, Good 11, Fair 2, Poor 1. Conclusion. The management of these injuries poses many difficulties to the trauma surgeon. With the available expertise in place good outcomes can be obtained as seen in this series of patients