High-energy pelvic ring injuries are associated with a significant rate of mortality and may require urgent stabilization with anterior pelvic external fixation. The iliac crest can be used for pin placement, but supra-acetabular pin placement is biomechanically superior. Traditionally, supra-acetabular pin placement is performed in the operating room, with time-consuming imaging techniques. However, because of the implicit high-energy nature of these injuries, patient physiology may prevent transport to the operating room and preclude the use of tedious image-guided techniques. Here, we describe a technique that can be performed at the bedside and without image guidance. [. 2022;45(5):e284-e287.].

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