![]() ![]() This classification is still the most commonly used classification system for the evaluation of pelvic ring injuries in orthopedic trauma surgery and is very useful in guiding initial management. The Young-Burgess classification distinguishes various pelvic ring injuries mechanistically, with common fracture patterns correlating with the direction of applied impact at the time of injury. Due to the amount of force that is required to fracture this ring, a fracture in one part of the pelvis is frequently accompanied by a fracture or damage to ligaments or structures within or outside of the pelvis. The bony pelvis, comprised of the ilium (iliac wings), ischium, and pubis, forms an anatomic ring with the sacrum. Damage to the corona intraoperatively can quickly result in the expiration of the patient due to excessive blood loss within the pelvis. The corona mortis is an anastomosis between the obturator artery (a branch of the internal iliac artery) and the external iliac artery. The venous plexus in the posterior pelvis accounts for the majority of hemorrhage associated with pelvic ring injuries. The posterior sacroiliac complex is one of the strongest ligaments in the body, and injury to the posterior ligaments reveals a very high energy mechanism of injury.ĭue to the high degree of soft tissue disruption associated with pelvic ring injuries, associated vascular, neurologic, and visceral injuries are common and must be ruled out. The posterior sacroiliac complex is the posterior-most ligamentous structure in the pelvic ring and is the most important structure for pelvic ring stability. The sacrospinous ligaments and sacrotuberous ligaments of the pelvic floor are anterior structures relative to the sacroiliac joint and resist both shear and external rotation through the sacroiliac joint. Posteriorly the ligaments of the pelvic floor and the posterior sacroiliac complex provide stability to the pelvic ring. On the anterior aspect of the pelvic ring, the symphyseal ligaments are present between the right and left pubic symphysis and serve to resist external rotation through the sacroiliac joints posteriorly. To understand and appropriately utilize the Young-Burgess classification system of pelvic ring injuries, clinicians must have a basic understanding of the pelvic ligamentous anatomy. By correctly identifying the pelvic ring injury, trauma surgeons and emergency physicians can provide adequate initial treatment, as well as convey important information about the anatomy of the injured structures to the orthopedic surgeon managing this patient. ![]() The Young-Burgess classification system is the most commonly utilized classification system in the evaluation of pelvic ring injuries and is expanded upon in detail below. Similarly, fractures of the acetabulum are a frequent occurrence, particularly in the setting of high energy traumas, hip dislocations, and falls in the elderly, and are studied in detail classified by the anatomy of the fracture. Certain types of pelvic fractures do not disrupt the pelvic ring, such as iliac wing fractures, which can typically be managed without operative intervention. Therefore, fractures of the pelvis occur most commonly in the setting of a high-impact trauma and are often associated with additional fractures or injuries elsewhere in the body. Due to the inherent structural and mechanical integrity of the pelvic ring, the pelvis is a highly stable structure.
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