The Tile classification of pelvic fractures is based on stability. A Type C fracture is defined as:

• A Stable — avulsion or iliac wing fracture without ring disruption
• B Completely unstable — rotationally AND vertically unstable (disrupted posterior sacroiliac complex) ✓
• C Partially stable — rotationally unstable but vertically stable (intact posterior sacroiliac complex)
• D Straddle fracture — bilateral superior and inferior pubic rami fractures only

Explanation

The Tile classification categorizes pelvic fractures by stability: Type A — stable (avulsions, iliac wing, non-displaced sacrum); Type B — rotationally unstable but vertically stable (open-book APC I/II, lateral compression); Type C — rotationally AND vertically unstable, implying complete disruption of the posterior sacroiliac ligamentous complex (sacroiliac joint dislocation or sacral fracture). Type C injuries have the highest mortality (up to 15–20%) due to arterial and venous bleeding. They require emergency stabilization, angioembolization for arterial bleeders, and definitive posterior ring fixation (SI screws or iliosacral instrumentation).

Reference: Maheshwari Essential Orthopaedics, 6th ed.

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Written and medically reviewed by the StethoPrep medical team.