ObjectiveTo analyze the treatment results from 20 patients who underwent an alternative osteosynthesis method as definitive treatment for pelvic ring fractures. MethodsA retrospective analysis was conducted on a series of 20 patients with pelvic ring fractures (Tile type C) and a high risk of postoperative infection, who were treated at Santa Casa de Misericórdia de São Paulo between August 2004 and December 2012. The patients underwent percutaneous supra‐acetabular external fixation in association with cannulated 7.0mm iliosacral screws. ResultsThe patients’ mean age was 40 years (range 22‐77 years) and the mean length of follow‐up was 18.5 months (range 3‐69 months). At the end of the treatment, ten patients (50%) were classified as having good results, nine patients (45%) had fair results and one patient (5%) did not have any improvement. Six patients presented complications, and paresthesia of the lateral femoral cutaneous nerve was the most frequent of these (two patients). ConclusionSupra‐acetabular external fixation in association with iliosacral percutaneous osteosynthesis is a good definitive treatment method for patients with a high risk of postoperative infection.