Review ArticleHigh-Energy Fractures of the Pelvis and Acetabulum in Pediatric PatientsGalos, David MD; Doering, Travis A. MDAuthor Information From the Department of Orthopaedic Surgery (Dr. Doering), Northwell Health, New Hyde Park, NY, and the Department of Orthopaedic Surgery, Nassau University Medical Center (Dr. Galos), East Meadow, NY. Neither of the following authors nor any immediate family member has received anything of value from or has stock or stock options held in a commercial company or institution related directly or indirectly to the subject of this article: Dr. Galos and Dr. Doering. Journal of the American Academy of Orthopaedic Surgeons: May 1, 2020 - Volume 28 - Issue 9 - p 353-362 doi: 10.5435/JAAOS-D-19-00082 Metrics Abstract Fractures of the pelvis and acetabulum, although uncommon in the pediatric cohort, represent a range of injuries with similarities to those seen in the adult cohort but with key differences that are important for the treating physician to be aware of to allow for systematic evaluation and management of these potentially life-threatening injuries. As the pediatric skeleton matures, changes in anatomy and physiology influence injury pattern, diagnosis, treatment, and complications. High-energy fractures of the pediatric pelvis are particularly concerning given the reported mortality rates ranging from 3.2% to 18%, with severe fracture patterns being associated with visceral injury in up to 60% of patients. The unique complexity of pediatric patients requires a multidisciplinary team to fully address their care. A systematic approach to the initial evaluation and diagnosis of pediatric patients with fractures of the acetabulum or pelvic ring aids in choosing between surgical and nonsurgical management of these fractures and avoiding complications unique to the maturing skeleton. We present such an approach to assist the practitioner who infrequently treats these uncommon injuries. Copyright 2019 by the American Academy of Orthopaedic Surgeons.