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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