Two patients were involved in a high-energy trauma that resulted in an unstable pelvic fracture. The first patient, a 51-year-old woman, was trapped between two boats. At our hospital she received a traumatic pelvic orthotic device (T-POD), followed by angiography with embolisation. Three days post-trauma she went to the operating room for definitive surgical treatment of her Tile C pelvic fracture. The second patient, a 19-year-old man, was in a car that collided with a tree. He also received a T-POD, but remained haemodynamically unstable. He went to the operating room for damage control surgery, followed by an angiography with embolisation. Two days later, definitive surgical treatment of the Tile C pelvic fracture took place. These cases illustrate the variety of possible treatments for patients with unstable pelvic fractures. Choice of treatment depends on the character of the attending injuries and the haemodynamic situation. Fast consultation should take place with a hospital experienced in the initial care and treatment of unstable pelvic fractures.