Tile classification of pelvic fractures

Last revised by Assoc Prof Craig Hacking on 23 Oct 2020

The Tile classification of pelvic fractures is the precursor of the more contemporary Young and Burgess classification of pelvic ring fractures.

It takes into account stability, force direction, and pathoanatomy. The integrity of the posterior arch determines the grade, with the posterior arch referring to all of the pelvis posterior to the acetabulum. Stability is defined as the 'ability of the pelvis to withstand physiologic force without deformation' by the original author 1.

Three basic stability descriptions are used, each with degrees of severity.

Classification

Type A

Stable (posterior arch intact)

  • A1: Avulsion injury
  • A2: Iliac-wing or anterior-arch fracture due to a direct blow
  • A3: Transverse sacrococcygeal fracture
Type B

Partially stable (incomplete disruption of the posterior arch)

  • B1: Open-book injury (external rotation)
  • B2: Lateral-compression injury (internal rotation)
    • B2-1: Ipsilateral anterior and posterior injuries
    • B2-2: Contralateral (bucket-handle) injuries
  • B3: Bilateral
Type C

Unstable (complete disruption of the posterior arch)

  • C1: Unilateral
    • C1-1: Iliac fracture
      • C1-2: Sacroiliac fracture-dislocation
    • C1-3: Sacral fracture
  • C2:  Bilateral, with one side type B, one side type C
  • C3:  Bilateral

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