MDCT of Pelvic Ring Disruptions


Good review of signs of rotational instability in pelvic fractures and Tile Classification

Tile Classification:


Tile classification 


  • A: stable
    • A1: fracture not involving the ring (avulsion or iliac wing fracture)
    • A2: stable or minimally displaced fracture of the ring
    • A3: transverse sacral fracture (Denis zone III sacral fracture)
  • 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 injury)
    • B3: bilateral
  • C – rotationally and 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

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