Tile M. The Journal of bone and joint surgery. British volume 1988 · PMID 3276697 · doi:10.1302/0301-620x.70b1.3276697
- Question
- Which pelvic ring fractures are stable enough for non-operative care and which need surgical stabilisation?
- Design
- Classic review and clinical series describing a stability-based classification of pelvic ring injury.
- Patients
- Adults with pelvic ring fractures.
- Intervention
- Stability-based classification (A stable, B rotationally unstable but vertically stable, C rotationally and vertically unstable) guiding fixation
- Comparison
- Non-operative management
- Primary outcome
- Long-term pain and function according to fracture type
- Key result
- Argued that stable (type A) injuries do well without surgery, whereas unstable injuries, particularly vertically unstable posterior ring disruptions, are associated with persistent pain and deformity and benefit from anatomical reduction and stable fixation.
- Limitations
- Expert opinion and observational data rather than comparative trials.
- Impact on practice
- The Tile (later AO/OTA) classification links fracture stability to the decision to fix and remains central to definitive pelvic ring management planning.