McMahon SE, et al. - In this study, the outcomes of a coned hemipelvis reconstruction and total hip arthroplasty inserted via a posterior approach to the hip as the primary treatment for this severely high-risk cohort were reported. A total of 22 cases (21 patients, mean age was 79 years, and the mean ASA score was 3.3) with a mean follow-up of 32 months (13 to 59) were included in this study. It was indicated that the coned hemipelvis reconstruction bypasses the fracture, creating an immediately stable construct that provides immediate full weight-bearing. In this vulnerable individual population, the posterior approach minimizes the operative time and physiological insult. The data suggested that early outcomes imply this to be a safe addition to current surgical options, targeted at the most medically frail elderly individual with a complex displaced acetabular fracture.