We report a case of an unstable vertical shear injury of the pelvis in a pregnant patient with a viable foetus. The combination of skeletal traction and pelvic external fixation failed to achieve satisfactory reduction. Open reduction and internal fixation of the pubic symphysis and the left sacro-iliac joint were performed without affecting the pregnancy. At the one-year follow-up, the patient was completely asymptomatic. We feel that surgical treatment of pelvic fractures can be offered to pregnant patients after thoroughly considering the potential benefits and dangers of surgery to the patient and the foetus.
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