In a retrospective review and follow-up study of 43 patients who had had high-energy pelvic fractures 5 or more years earlier, the occurrence of late pain and the functional outcome were adversely related to residual deformity of the pelvic ring. Among patients who had no residual deformity (displacement less than 1 cm), 88% had no serious pain and 82% had normal function. Of patients who had residual deformity (displacement more than 1 cm posteriorly), only 30% had no serious pain (p less than 0.01) and only 30% had normal function (p less than 0.01). Definitive reduction and stabilization is therefore recommended early after the injury whenever possible.