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The Tile classification of pelvic fractures is based on stability rather than mechanism and is considered the precursor of the Young and Burgess system. Isolated stable pelvic fractures can also occur in the context of lower energy mechanisms or sporting injuries: acetabular fracture; pubic ramus fracture; iliac wing fracture (Duverney fracture)
The Young and Burgess classification is a modification of the earlier Tile classification 1.It is the recommended 5 and most widely used classification system for pelvic ring fractures.It takes into account force type, severity, and direction, as well as injury instability. Three basic mechanistic descriptions are used, each with degrees of severity.
The Tile classification of pelvic fractures is the precursor of the more contemporary Young and Burgess classification of pelvic ring fractures.. It takes into account stability, force direction, and pathoanatomy. The integrity of the posterior arch determines the grade, with the posterior arch referring to all of the pelvis posterior to the acetabulum.
Pathology. It comprises of two ipsilateral pelvic ring fractures, which are vertically oriented: anterior to the acetabulum. posterior to the acetabulum. Most commonly there is disruption of the ipsilateral superior and inferior pubic rami and sacroiliac joint. Common variants involve the ilium or sacral wing rather than the sacroiliac joint.
posterior wall fracture. fracture detaching fragment(s) consisting of the posterior articular surface and/or the weight-bearing dome from most of the posterior column, but sparing the quadrilateral plate 5,9 only pattern in the Judet-Letournel classification that spares the quadrilateral plate 5
Open book pelvic injuries result from an anteroposterior compression injury to the pelvis and result in a combination of ligamentous rupture and/or fractures to both the anterior and posterior arches 5: anterior arch: pubic diastasis (+/- sacrotuberous / sacrospinous ligamentous disruption) and/or pubic rami fractures.
The femoral neck is the weakest part of the femur. Since disruption of blood supply to the femoral head is dependent on the type of fracture and causes significant morbidity, the diagnosis and classification of these fractures is important. There are three types: subcapital: femoral head/neck junction. transcervical: midportion of femoral neck.
A1: injury to the coccygeal region or compression injuries including that of ligamentous avulsion fractures. A2: fractures below the level of the sacroiliac joint that are non-displaced and transverse in orientation. A3: fractures below the level of the sacroiliac joint that are displaced and transverse in orientation. B: posterior pelvic injuries
Weber B fractures could be further subclassified as 9. B1: isolated. B2: associated with a medial lesion (malleolus or ligament) B3: associated with a medial lesion and fracture of posterolateral tibia. type C. above the level of the syndesmosis (suprasyndesmotic) tibiofibular syndesmosis disruption with widening of the distal tibiofibular ...
Usage. The Winquist system is commonly used along with the AO/OTA classification of femoral diaphyseal fractures 4.. This classification was originally used to assist (along with other factors) in deciding whether a fracture requires an intramedullary nail or open reduction, which was important at the time of the classification's publication 5.However, intramedullary nailing is now considered ...