Pelvic and acetabular fractures remain a challenge for all those involved in their assessment and management. Pelvic injuries account for 3% of all musculoskeletal trauma and occur in 4–18% of those sustaining high-energy trauma such as motor vehicle accidents and falls from heights. Males are twice as likely to be affected as females. Road traffic accidents account for 73% of pelvic fractures. Mortality rates in patients with pelvic fractures have been reported to range from 9 to 27%. However, improved early care has resulted in a reduction of morbidity as well as mortality.

It is important to note that there are significant differences between pelvic and acetabular fractures, the most notable being that the former can be associated with major haemorrhage, depending on the fracture pattern. Acetabular fractures will only rarely be associated with significant bleeding. Furthermore acetabular fractures will be associated with late post-traumatic arthritis if there is major primary articular surface loss or if the fracture remains poorly reduced after treatment. Thus delays in referral to an appropriate centre that specialises in the treatment of pelvic and pelvic–acetabular fractures will allow callus formation that hinders the possibility of complete surgical reduction of the fracture. Pelvic fractures on the other hand are often associated with gross haemodynamic and skeletal instability. The type of pelvic fracture is strongly related to the mechanism of injury, thus the taking of an accurate history is extremely important.