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How to Classify Pelvic Fractures, Part 2: Tile Classification

Classification of Pelvic Fractures

The two most common classifications of pelvic fractures are the Tile Classification and the Young-Burgess Classification.

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Tile Classification of Pelvic Fractures

The Tile classification is based on stability. There are 3 major classifications: A (stable), B (rotationally unstable, vertically stable), and C (rotationally and vertically unstable).

Tile A: Stable

  • A1: fracture not involving the ring (avulsion or iliac wing)
  • A2: stable or minimally displaced fracture of the ring
  • A3: transverse sacral fracture (Denis Zone III sacral fracture)

Tile B: Rotationally unstable, vertically stable

  • B1: open book injury (external rotation)
  • B2: lateral compression injury (internal rotation)
    • B2-1: with anterior ring rotation/displacement through ipsilateral rami
    • B2-2: with anterior ring rotation/displacement through contralateral rami (bucket handle)
  • B3: bilateral 

Tile C: Rotationally unstable, vertically unstable

  • C1: unilateral
    • C1-1: iliac fracture
    • C1-2: sacroiliac fracture dislocation
    • C1-3: sacral fracture
  • C2: bilateral with one side type B and one side type C
  • C3: bilateral with both sides type C

 

References

  1. Guthrie HC, Owens RW, Bircher MD. Fractures of the pelvis. J Bone Joint Surg Br. 2010 Nov;92(11):1481-8. doi: 10.1302/0301-620X.92B11.25911. Review. PubMed PMID: 21037339.
  2. Browner’s Skeletal Trauma: Basic Science, Management, and Reconstruction (5th Edition)
  3. AO: Fractures of the Pelvis and Acetabulum
  4. Alton, T. B., & Gee, A. O. (2014). Classifications in Brief: Young and Burgess Classification of Pelvic Ring Injuries. Clinical Orthopaedics and Related Research, 472(8), 2338–2342. http://doi.org/10.1007/s11999-014-3693-8

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