- Younger patients (from 20 to 50 years of age) – high-energy vehicular trauma or falls from significant heights,
- Older patients (from 60 to 80 years of age) – low-energy falls and concomitant osteoporosis
- Posterior column: Quadrilateral surface, Posterior wall and dome, Ischial tuberosity, Greater/lesser sciatic notches
- Anterior column: ilium (gluteus medius tubercle), Anterior wall and dome, Iliopectineal eminence, Lateral superior pubic ramus
- X rays AP, obturator oblique, iliac oblique, inlet/outlet
- CT scan – gold standard in management
- Open contaminated wound, Late presenting > 3 weeks, Minimally displaced fracture (< 2 mm): treat non operatively
- Open reduction and fixation : Displacement of roof (> 2 mm), Unstable fracture pattern (e.g. posterior wall fracture involving > 40-50%), Marginal impaction, Intra-articular loose bodies, Irreducible fracture-dislocation
- Complications: Post-traumatic arthritis, Heterotopic ossification, Osteonecrosis, DVT and PE etc
