using lag screw(s) and to neutralize forces across the bone one needs to add plate(s) on the surface of the fractured fragments for it to heal without deformity. before surgery, patient needs tests to check fitness for surgery anaesthesia : the surgery may be performed either under regional anaesthesia or general anaesthesia surgical approaches. following are the common approaches; kocher langenbeck approach for posterior injuries ili inguinal, ilio femoral of modified stoppa's approach for anterior or combined injuries implants : normally lag screws and reconstruction plates are preferred implants post operative management: would involve initial period or bed rest, followed by mobilisation by trained therapist total time to recover may be up to 3 months elderly patients have worse outcomes than other populations. studies show that over 20 percent will require subsequent total hip arthroplasty. gallery acetabular fracture axial ct image (viewed on bone windows) of a complex comminuted left acetabular fracture involving both anterior and posterior columns. fracture of the acetabulum elementary fractures posterior wall fracture posterior wall fracture as seen on 3-d ct scan posterior wall fracture fixed with screws and plate function after fixation anterior wall fracture anterior wall fracture as seen on 3d ct image fixation with screws and plate anterior column fracture high anterior column fracture 3 d ct scan picture high anterior column fracture after fixation with screws and plates transverse fracture transverse fracture showing upper iliac fragment, lower ischial and pubic fragment transverse fracture fixed with screws and plate associated fractures t-shaped fracture (associated with posterior wall fracture) t shape fracture shown on bone model x-ray of t shape fracture posterior column with posterior wall (associated with posterior column fracture) posterior column and wall fracture as seen on 3d ct posterior column and wall fixed using screws and plates combined both column fractures (associated with transverse fracture) both column fracture showing floating weight bearing dome both column fracture after fixation with screws and plates function after fixation both column fracture