Young and Burgess classification of pelvic ring fractures

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.

For a broader description of pelvic injury types, see pelvic fractures.

Classification

Anteroposterior compression (APC)

• APC I: stable

  • pubic diastasis <2.5 cm

• APC II: rotationally unstable, vertically stable

  • pubic diastasis >2.5 cm

  • disruption and diastasis of the anterior part of the sacroiliac joint, with intact posterior sacroiliac joint ligaments

• APC III: equates to a complete hemipelvis separation (but without vertical displacement); unstable

  • pubic diastasis >2.5 cm

  • disruption-diastasis of both anterior and posterior sacroiliac joint ligaments with dislocation

Lateral compression (LC)

Most common type.

• LC I: stable

  • oblique fracture of pubic rami

  • ipsilateral anterior compression fracture of the sacral ala

• LC II: rotationally unstable, vertically stable​

  • fracture of pubic rami

  • posterior fracture with dislocation of the ipsilateral iliac wing (crescent fracture)

• LC III: unstable

  • ipsilateral lateral compression (LC)

  • contralateral anteroposterior compression (APC)

Vertical shear (VS)

Most severe and unstable type with a high association of visceral injuries.

• vertical displacement of hemipelvis, pubic and sacroiliac joint fractures

Combined

Stability depends on the individual components of this injury.

• complex fracture, including a combination of anteroposterior compression (APC), lateral compression (LC), and/or vertical shear (VS)