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