Acetabular fracture has always been a difficult point in clinical treatment. Because of its many complications and poor prognosis, and the operation itself is more difficult than limb surgery, the treatment effect is often unsatisfactory. I hope teachers can provide relevant experience to learn. Let's talk about my humble opinion first, for reference only! From the X-ray film and CT, the patient's diagnosis is clear, and the posterior dislocation of the left hip joint with acetabular posterior wall and femoral head fracture should belong to PipkinII type. Combined with the patient's condition, surgical indications are available. First, surgical contraindications and treatment of combined injuries should be ruled out, heavy bone traction should be performed, and after improving the examination, surgery should be performed as soon as possible to provide blood supply for the fracture as soon as possible, so as to minimize the chance of late femoral head necrosis. The surgical approach can be posterolateral approach to open reduction of femoral head fracture, acetabular posterior wall fracture and dislocation of hip joint. Internal fixation options, acetabular fracture reconstruction pelvic plate and femoral head fracture can be internally fixed with absorbable screws. The advantage of this surgical approach is that it is convenient and thorough to expose, and the most important thing is that these problems can be solved simultaneously in one incision. The patients suffered from severe violence, such as dislocation of hip joint, acetabular fracture, fracture of femoral head, serious injury of cartilage surface of femoral head, and high incidence of late femoral head necrosis and traumatic arthritis. After operation, the bone traction of the affected limb was maintained for 6~8 weeks, and the hip joint roughening exercise was performed intermittently during this period to reduce the later complications. After operation, hyperbaric oxygen and traditional Chinese medicine can be assisted to promote fracture healing and reduce the necrosis rate of femoral head. We must fully communicate with patients and their families before operation, so that they can fully understand the seriousness of this condition and the poor prognosis!