A case of 22 years old male brought to emergency with history of road traffic accident presented with posterior pelvic ring injury, straddle fracture with pubic diastasis and bilateral anterior acetabulum column fracture. Emergency management was done according to damage control orthopaedics and external fixator was applied. After 5 days, definitive surgery was done using special percutaneous surgical technique for fixation of vertical sacral fracture and bilateral anterior column fracture of acetabulum.

For left vertical sacral fracture and left sacro-iliac joint dislocation, a percutaneous ilio-sacral customize screw was placed. For bilateral acetabulum fracture, percutaneous screws were placed in bilateral anterior acetabulum column. And straddle fracture with pubic diastasis was fixed with antomical locking pubic symphysial plate taking pfannenstiel incision.

Adequate fracture fixation was achieved and patient was allowed weight bearing 1 month post operative.