Letournel Classification



- Discussion:
    - classified pelvic ring injuries simply according to site of injury;
    - anterior disruption can occur thru either pubic symphysis or pubic rami;
    - injury may be through the ilium, the SI joint, or the sacrum;
    - it can involve frx-dislocation of SI joint, which commonly involves frx through most posterior portion of iliac wing that crosses joint;
    - frx line leaves a portion of ilium in its nl position, articulating w/upper portion of the SI joint;
    - more anterior portion of the ilium dislocates from lower SI joint;
    - acetabular fracture is another possible site of pelvic ring disruption;
    - Classification includes ten fracture types subdivided by 5 simple frx:
         - posterior wall;
         - Posterior Column;
         - Anterior wall;
         - anterior column;
         - Transverse frx
    - combined frx types include combined posterior wall & post column frx, or posterior wall and Transverse frx as well as several more complex patterns;
         - T-shaped fracture combines a transverse component & vertical component that separates the lower ischiopubic segment into the anterior and posterior columns.
         - second type combines anterior and posterior hemitransverse frx, w/ anterior column or Anterior wall predominating in displacement;
         - low and usually minimally displaced posterior hemitransverse component is present;
         - in both column frx, all segments of the articular surface are detached from the ilium



Original Text by Clifford R. Wheeless, III, MD.

Last updated by Data Trace Staff on Thursday, September 6, 2012 2:02 pm