Background: Pelvic and acetabular fractures are a subset of orthopaedic injuries which result from high- and low-energy trauma mechanisms. This literature review’s objective is to provide an overview of the epidemiology, patient outcomes, and management of pelvic and acetabular fractures, with an emphasis on low-energy fractures.

Methods: A literature search was conducted using papers up to May 2024.

Results: Epidemiologically, increased incidence of pelvic and acetabular fractures is observed in socioeconomically deprived areas and is influenced by patient age, sex, and ethnicity. Negative patient outcomes are associated with the presence of certain pre-morbid variables, namely increased frailty status, significant comorbidities, low mobility status, and obesity. Management of these fractures can constitute either conservative or surgical approaches, which are reported to yield comparable results. Many management-related variables have been identified to also influence patient outcomes, including length of hospital stay, delays to surgery, discharge destinations, post-operative complications, and surgeon experience. Modern research indicates early post-operative weight bearing and mobilization to help promote fracture recovery. Recent development in the care of these fractures includes the regionalization of major trauma centres. Numerous studies link increased mortality risk with advanced age, frailty, low pre-fracture mobility, comorbidities, inpatient discharges, and post-operative complications. Evidence in the association between length of stay and mortality is less clear, with contradictory findings reported regarding the effects of short versus long stays.  

Conclusions: Overall, patient outcomes were significantly influenced by the aforementioned variables, but there is a lack of consensus and research regarding their impact.