目的　探讨根据骨盆的形态特点选择不同的内固定手术治疗不稳定型骨盆骨折的临床应用价值。   方法　65例不稳定型骨盆骨折，31例Tile B型骨折经前入路，将耻骨联合或耻骨支复位用重建钢板固定，其中8例合并髂骨骨折经髂窝入路将之复位用重建钢板固定；34例Tile C型骨折的前环损伤均采用与Tile B型骨盆骨折相同的方法处理，后环损伤的固定方法：17例骶骨骨折或骶髂关节脱位之中，复位后在透视引导下从后方经皮骶髂螺钉固定11例，经髂骨的螺栓固定4例，经后路在双侧髂骨后嵴之间用张力带钢板固定2例；9例骶髂关节骨折-脱位之中，经皮骶髂螺钉固定6例，钢板固定3例；8例合并髋臼骨折行重建钢板内固定。  结果　通过对术后骨盆X线测量骨折分离移位的最大距离，根据Matta评分标准：小于4 mm为优，占86.1%（56例）；4~10 mm为良，占7.7%（5例）；10~20 mm为可，占6.2%（4例）；大于20 mm为差（0例）。本组骨盆X线测量结果总优良率为93.8%。  结论    不稳定型骨盆骨折应在血流动力学稳定时尽早根据骨折的类型及骨盆的解剖形态特点选择合理的内固定手术方案。

Objective　To explore clinical efficiency of different surgical internal fixations on treating the unstable pelvic fracture according to the anatomic features of the pelvis.　Methods　65 cases suffering from the unstable pelvic fractures, were included in this study. Anterior approach, with the replacement and plate fixation of symphysis pubis or ramus of pubis, was performed for 31 cases of Tile B type fracture. 8 cases combined with ilium fracture among them were replaced and fixed through iliac fossa approach. As well, anterior approach also was used for fixing damaged anterior girdle of 34 cases of Tile C type fracture. However, the damaged posterior girdles were treated with the replacement and the posterior sacroiliac screw fixation under X-ray guide for 11 among 17 cases of sacral bone fracture or dislocation of sacroiliac joint, while, 4 cases treated with transiliac gudgeon fixation, 2 cases with tensile plates fixation between bilateral posterior iliac spine through posterior approach. For 9 cases of sacroiliac joint fracture and dislocation, 6 fixed with transdermal screw, and 3 with the plate. 8 cases combined with acetabulum fracture were fixed with the plate. Results　According to the index of Matta score, which analyzed the greatest distance of the pelvic fracture displacement under X-ray evaluation, 56 cases (86.1%) were excellent, with the shorter displaced distance of the less of 4mm, 5 cases(7.7%)  were fine, with the displaced distance of 4~10mm, 4 cases (6.2%) were better, with the displaced distance of 10~20mm, and no case was bad, with the greater displacement distance of 20 mm. Conclusions　It is important to select reasonable internal fixation proposal for treating the unstable pelvic fracture, according to the different fracture types and anatomic features of pelvis.