Treatment of patients with acetabulum fractures (AF) remains a big challenge for orthopaedists and traumatologists. Suchfractures are known for their complications that lead to disability. Objective. To analyze the results of treatment of patientswith AF and complications that arise depending on the of the injury mechanism and the method of treatment, to evaluate the effectiveness available methods of preventing the development of these complications. Methods. A retrospective study wasdone on the basis of 89 AF patients analysis (age 17‒75 years, 22 women and 67 men) with different terms after the fracture.The majority of patients got primary care in other clinics. Diagnostic measures: clinical examination; X-ray examinationof the pelvis, that under conditions of acute injuries were supplemented with CT scan; ultrasound of abdominal cavity,chest X-ray, brain MRI, electroneuromyography of the lower limbs. Results. Most AF occurred as a result of traffic accidents.The most common types are A1 and B1 according to the classification of AO/ASIF. The system of skeletal traction has beenapplied often at the stage of primary treatment. During surgical treatment the Kocher-Langenbeck approach and osteosynthesis was mainly used to stabilize the posterior wall and acetabulum column. The typical complications of AF are coxarthrosis, femoral head aseptic necrosis despite the chosen treatment tactics. Their clinical manifestation with the hip impaired function occurred within a year after the trauma. Defined complications led to the need for total hip replacement in 67 (75.3 %) cases out of 89. In 8 patients, total hip replacement was performed in the acute period of injury and it was possible to restore the joint function with better early functional results compared to the rest of the patients. Conclusions. Primary total hip replacement in the case of AF is an effective treatment measure that gives the posibility restore the function of the hip joint in the shortest time and prevent the development of typical complications.