Objective To study the strategies and clinical effects of internal fixation for the pelvic plus acetabular fractures.Methods From January 2004 to June 2013,127 patients diagnosed with pelvic plus acetabular fractures were treated with open reduction and internal fixation in our hospital.They were 87 males and 40 females,aged from 14 to 69 (average,35.6) years.After shock and fatal injuries were dealt with,the unstable pelvic fractures were immobilized with temporary external fixation or leg traction.The time from injury to surgery ranged from 4 hours to 71 days,with an average of 10.5 days.All the acetabular fractures were fixated with a reconstruction plate and/or screws.For pelvic fractures,the symphysis pubis and fractures of the pubic rami were fixated with a reconstruction plate in 81 cases,percutaneous fixation with pubic rami screws was performed in 7,fixation with iliac screws and a reconstruction plate in 23,fixation with an anterior sacroiliac plate in 12,percutaneous fixation with iliosacral screws in 8,fixation with a posterior iliac crest M plate in 11,and iliolumbar fixation in 5.Results The reduction of acetabular fracture was anatomic in 66 cases,satisfactory in 53,and unsatisfactory in 8,giving a satisfaction rate of 93.7%.103 cases were followed up for an average of 25 months (from 6 to 48 months).Pelvic functional results were excellent in 52 cases,good in 36,fair in 12,and poor in 3 according to the Majeed system,with an excellent to good rate of 85.4%.Hip functions,according to the modified d'Aubigne system,were excellent in 54 cases,good in 32,fair in 13,and poor in 4,with an excellent to good rate of 83.5%.Postoperative complications included ipsilateral hip traumatic arthritis in 17 cases,femoral head necrosis in 2,incision fat liquefaction in 5,incision infection in one,deep venous thrombosis in 11,and heterotypic ossification in 4.Conclusions Pelvic fractures with concomitant acetabular fractures should be treated according to an individualized protocol.Shock and fatal injuries should be treated first before temporary fixation of the fractures.Definitive internal fixation should not be performed until the vital signs are stable 7 to 10 days later.Early physical therapy and functional exercise are important strategies to obtain satisfactory clinical outcomes Key words: Pelvis; Acetabulum; Fractures, bone ; Fractures fixation; Postoperative complications