Cryer et al classified pelvic fractures based on the initial anteroposterior (AP) radiograph of the pelvis. This can help identify pelvic fractures that are more likely to have associated lesions that are clinically significant. The authors are from the University of Louisville in Louisville, Kentucky.


Pelvic fractures were classified using the method of Pennel and Sutherland:

(1) Type I (anterioposterior compression)

(2) Type II (lateral compression)

(3) Type III (vertical shear)


Pelvic fractures were defined as being unstable if:at least one of the following is present:

(1) any bone displacement > 0.5 cm

(2) an open book fracture (Type I fracture with disruption of the pubic symphysis)


If a pelvic fracture was defined as stable if neither condition was present.


A patient with an unstable pelvic fracture is more likely to have:

(1) blood loss >= 4 units (60% vs 20% if stable fracture)

(2) intra-abdominal injury (45% vs 14%)

(3) arterial injury (11% vs 0%)


Some classifications of pelvic fractures such as the Tile method require multiple different radiographic views, CT scan or MRI which may not be immediately available. In addition, a complete classification is more important for an orthopedic reconstruction rather than the immediate patient management when exsanguination and stabilization are major concerns.


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