Baron MD, Cazan B, Agel J, et al. - To manage unstable pelvic ring injuries produced by external rotation of the hemipelvis and a symphyseal disruption, internal fixation of the anterior ring, with percutaneous treatment of the posterior ring, are most often performed and in some clinical situations, external fixation is done for the anterior injuries. Researchers here examined whether functional outcomes differ between treatment of these injuries with internal vs external fixation, when measured at a minimum of 3 years after injury. For this a retrospective cohort study, trauma database at one regional trauma center yielded data from 128 patients. Of these patients, 70 were subsequently excluded, with unstable anterior posterior compression (APC) pelvic ring injuries (OTA 61B2.3 & 61C1.2) treated with surgery with minimum three years of follow-up. Subgroups of the Majeed functional outcome score (0-100) were not significantly different. Those treated with external fixation had worse open fractures, severity of injury, and ISS. Outcomes revealed no different long term outcomes among patients with unstable pelvic ring injuries with symphyseal disruptions treated with external fixation as definitive treatment vs internal fixation.