According to Young and Burgess classification, which type of pelvic ring injury is associated with the highest risk of major vascular injury and hemorrhage?

• A Lateral compression Type I (LC-I)
• B Anterior-posterior compression Type I (APC-I)
• C Lateral compression Type II (LC-II)
• D Anterior-posterior compression Type III (APC-III) ✓

Explanation

APC-III (open book pelvis with complete disruption of both sacroiliac and sacrospinous/sacrotuberous ligaments) causes maximum pelvic ring instability, dramatically expanding pelvic volume and allowing massive haemorrhage from the presacral venous plexus and iliac vessels. Average blood loss approaches 3,000–4,000 mL. LC injuries (compressive forces that close the pelvis) are associated with less haemorrhage. Emergent pelvic binder application, pre-peritoneal packing, and/or angioembolisation are required.

Reference: Maheshwari Essential Orthopaedics, 6th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.