The decision for operative or nonoperative treatment of pelvic ring injuries is based on:
Fracture stability, displacement, and pattern
Surgical skill and availability of equipment
Pelvic ring stability is assessed by the type and location of fractures and joint injuries involving the pelvic ring.
Displaced lower sacral fractures may compromise sacral plexus neurologic function which should be assessed to exclude the need for surgery. If the patient is neurologically normal and deformity is acceptable, activities can be allowed as tolerated with cushions for sitting.