A 35-year-old man sustains a pelvic ring injury in a road traffic accident. Radiograph shows symphyseal diastasis of 3 cm with disruption of the anterior sacroiliac ligaments, but the posterior sacroiliac ligaments remain intact. According to the Tile classification, this is classified as:

• A Tile A
• B Tile C
• C Tile B2
• D Tile B1 ✓

Explanation

Tile D1 injury is a partially stable injury with external rotation instability. It involves symphyseal diastasis or pubic rami fractures with disruption of the anterior sacroiliac ligaments, while the posterior sacroiliac ligaments remain intact. This is the classic 'open book' injury. Tile D2 is internal rotation instability (lateral compression). Tile C involves complete disruption of posterior sacroiliac ligaments with vertical instability.

Reference: Rockwood and Green's Fractures in Adults, 9th ed.

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Written and medically reviewed by the StethoPrep medical team.