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Pelvis/Hip Case 11 Background

Injuries in which the pubic symphysis is disrupted and the pelvis is forced open are also referred to as open book fractures.

Pelvic fracture patterns are often described by the mechanisms of the forces applied, which can be described as lateral compression (LC), anteriorposterior compression (APC), or vertical shear (VS). The fractures can then be classified by applying the Young Burgess or Tile classification systems (the details of which are beyond the scope of this brief teaching). While the patterns are often mixed, the characterization is often useful in determining structural stability and hemorrhage likelihood.

APC mechanisms force the iliac wings out, disrupting the pubic symphysis. Pelvic volume is increased, so the patient is at risk for uncontained hemorrhage. The pelvis provides stability in two planes: rotationally and vertically. APC injuries are unstable rotationally. Vertical stability depends on whether the posterior structures are involved.