Pelvic fracture classifications

Question 1

Young and Burgess LC

Answer 1

Implosion of the pelvis secondary to laterally applied force that shortens the anterior sacroiliac, sacrospinous, and sacrotuberous ligaments

Question 2

LC Type I

Answer 2

Sacral impaction on the side of impact. Transverse fractures of the pubic rami are stable

Question 3

LC Type II

Answer 3

Posterior iliac wing fracture (crescent) on the side of impact with variable disruption of the posterior ligamentous structures

Question 4

LC Type III

Answer 4

LC-I or LC-II injury on the side of impact; force continued to contralateral hemipelvis to produce an external rotation injury (windswept pelvis). Instability may result with hemorrhage and neurologic injury secondary to traction injury on the side of sacroiliac injury

Question 5

Young and Burgess AP

Answer 5

anteriorly applied force from direct impact or indirectly transferred via the lower extermities or ischial tuberosities resulting in external rotation injuries, symphysis diastasis, or longitudinal rami fractures

Question 6

AP Type I

Answer 6

Less than 2.5 cm of symphysis diastasis. Vertical fractures of one or both pubic rami occur, with intact posterior ligaments

Question 7

AP Type II

Answer 7

More than 2.5 cm of symphysis diastasis; widening of sacroiliac joints; caused by anterior sacroiliac ligament disruption. “Open book” injury with internal and external rotational instability; vertical stability is maintained

Question 8

AP Type III

Answer 8

Complete disruption of the symphysis, sacrotuberous, sacrospinous, and sacroiliac ligaments resulting in extreme rotational instability and lateral displacement; no cephaloposterior displacement. Completely unstable with highest rate of associated vascular injuries and blood loss

Question 9

Young and Burgess VS

Answer 9

Vertically or longitudinally applied forces caused by falls onto an extended lower extremity, impacts from above, or motor vehicle accidents with an extended lower extremity against the floorboard or dashboard. Associated with complete disruption of the symphysis, sacrotuberous, sacrospinous, and sacroiliac ligaments and result in extreme instability, most commonly in a cephaloposterior direction because of the inclination of the pelvis. Highly associated with incidence of neurovascular injury and hemorrhage.

Question 10

Young and Burgess CM

Answer 10

Combined Mechanical: combination of injuries often resulting from crush mechanisms, most commonly VS and LC