Twenty-five patients with double vertical fractures of the pelvic ring
had evaluations by both plain radiography and computed-tomography scanning
of the pelvis. In eight of the twenty-five patients, the interpretation
that was made from the plain radiographs, based on the classification of
Pennal et al., changed when additional anatomical information was provided
by the computed-tomography scan. We recommend that computed tomography be
used for: (1) double vertical fracture-dislocations of the pelvic ring in
which plain radiographs are inadequate to judge pelvic stability, (2)
fractures of the pelvic ring with extension into the acetabulum, and (3)
major injuries to the hemipelvis that are to be treated by open reduction
and internal fixation. However, due to the increased cost and radiation
exposure, routine computed-tomography scanning is not justified for all
injuries to the pelvic ring.