Despite renewed interest in the reduction and external fixation of
pelvic disruptions, anatomical studies of such injuries are lacking. Of 150
consecutive victims of multiple trauma examined at autopsy, forty-seven (31
per cent) were found to have a pelvic injury. Twenty-six of the thirty-two
cadavera that were examined radiographically and dissected had a double
break in the pelvic ring (Malgaigne pattern). An anatomical classification
based on the degree of posterior injury to the ring is proposed. Anatomical
reduction of the posterior fracture-dislocation by external manipulation
was impossible in the majority of cadavera because of either ligamentous or
osseous interposition, or both, in the sacro-iliac joint, or because of
triplane displacement of the hemipelvis.