Abstract: Objective To study the therapeutic effect of open reduction and internal fixation in the management of old vertical unstable pelvic fractures. Methods In the 9 cases with surgical treatment for pelvic fractures, combination of the anterior and posterior approaches was adopted. Results In the follow-up lasting for 6-30 months, all pelvic fractures were reduced satisfac-torily. The 9 patients were able to walk and 8 of them gained good clinical recovery without complications. Conclusion In the management of old vertical unstable pelvic fractures, a stable pelvis can be reconstructed by effective open reduction and internal fixation through combination of the anterior and posterior approaches, so that further sequelae can be reduced.