The pathological anatomy of Malgaigne fracture-dislocations of the pelvis

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 cadavers that were examined radiographically and dissected had a double break in the pelvic ring (Malgairgne 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 cadavers because of either ligamentous or osseous interposition, or both, in the sacro-iliac joint, or because of triplane displacement of the hemipelvis.