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Bucholz Classification

Discussion

  • based on the assessment of stability;
  • lesions are graded as Type I, Type II, or Type III depending on degree of instability;
  • Bucholz noted that on postmortem dissection of pts w/ pelvic fractures that all injuries to pelvic ring had some injury to both anterior and posterior portions of the pelvis;

Type I

  • injuries for which the roentgenograms reveal only anterior rami frxs demonstrated at least hemorrhage & partial disruption of posterior SI ligaments;

Type II

  • lesion is similar to the AP compression lesion;
  • it is characterized by the presence of anterior instability and partial posterior instability.

Type III

  • lesion demonstrates complete anterior and posterior instability;
  • it may be due to vertical shear, Lateral Compression, or complex mechanism of injury;
  • instability is secondary to both the bony and the ligamentous disruption of pelvic ring;
  • degree of ligamentous disruption is a key to stability because fracture alone will not produce instability without associated displacement and ligamentous disruption