Young and Burgess Classification

Last updated: July 6, 2026Reviewed date: July 6, 2026Reading time: 5 min read

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The Young and Burgess classification is a modified form of the earlier Tile classification for allowing judgment on pelvic stability. It is the recommended and most widely used classification system for pelvic ring fractures, and ligament injury. There are several types of fracture managing methods for classifying, investigating the fracture pattern, severity, degree, location, type, angulation, shortening – lengthening, comminution, rotation, displacement, the status of the...

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This article explains Young and Burgess classification of pelvic ring fractures in simple medical language.

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Written byDr. Harun Ar Rashid, MD - Arthritis, Bones, Joints Pain, Trauma, and Internal Medicine Specialist

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Definition

The Young and Burgess classification is a modified form of the earlier Tile classification for allowing judgment on pelvic stability. It is the recommended and most widely used classification system for pelvic ring fractures, and ligament injury. There are several types of fracture managing methods for classifying, investigating the fracture pattern, severity, degree, location, type, angulation, shortening – lengthening, comminution, rotation, displacement, the status of the pelvic implant, the quality of surrounding pelvic soft tissue injury and fracture angle are universally and widely accepted by orthopedic surgeons to assess the initial injury, plan management, and predict prognosis, diagnosis to manage decision making, in determining whether a fracture requires an intramedullary nail or open reduction with internal fixation with steel screws, rods, plates, pins, or K-wires to hold the broken bones in the correct position even external fixation attaches a metal framework outside the limb and includes the Ilizarov method and an X-frame.

Young and Burgess classification of pelvic ring fractures

Classification

Anteroposterior compression (APC)

APC I: stable
- pubic diastasis <2.5 cm
APC II: rotationally unstable, vertically stable
- pubic diastasis >2.5 cm
- disruption and diastasis of the anterior part of the sacroiliac joint, with intact posterior sacroiliac joint ligaments
APC III: equates to a complete hemipelvis separation (but without vertical displacement); unstable
- pubic diastasis >2.5 cm
- disruption-diastasis of both anterior and posterior sacroiliac joint ligaments with dislocation

Lateral compression (LC)

Most common type.

LC I: stable
- oblique fracture of pubic rami
- ipsilateral anterior compression fracture of the sacral ala
LC II: rotationally unstable, vertically stable
- fracture of pubic rami
- posterior fracture with dislocation of the ipsilateral iliac wing (crescent fracture)
LC III: unstable
- ipsilateral lateral compression (LC)
- contralateral anteroposterior compression (APC)

Vertical shear (VS)

Most severe and unstable type with a high association of visceral injuries.

vertical displacement of hemipelvis, pubic and sacroiliac joint fractures

Combined

Stability depends on the individual components of this injury.

complex fracture, including a combination of anteroposterior compression (APC), lateral compression (LC), and/or vertical shear (VS)

Young and Burgess Classification

Tile classification

Tile classification
A: Stable
	A1: fracture not involving the ring (avulsion or iliac wing fracture)
	A2: stable or minimally displaced fracture of the ring
	A3: transverse sacral fracture (Denis zone III sacral fracture)
B: Rotationally unstable, vertically stable
	B1: open-book injury (external rotation)
	B2: lateral compression injury (internal rotation)
	B2-1: with anterior ring rotation/displacement through ipsilateral rami
	B2-2-with anterior ring rotation/displacement through contralateral rami (bucket-handle injury)
	B3: bilateral
C: Rotationally and vertically unstable
	C1: unilateral
	C1-1: iliac fracture
	C1-2: sacroiliac fracture-dislocation
	C1-3: sacral fracture
	C2: bilateral with one side type B and one side type C
	C3: bilateral with both sides type C

Young-Burgess Classification

Anterior Posterior Compression (APC)
APC I	Symphysis widening < 2.5 cm
APC II	Symphysis widening > 2.5 cm. Anterior SI joint diastasis. Posterior SI ligaments are intact. Disruption of sacrospinous and sacrotuberous ligaments
APC III	Disruption of anterior and posterior SI ligaments (SI dislocation). Disruption of sacrospinous and sacrotuberous ligaments. APCIII associated with vascular injury

Lateral Compression (LC)
LC I	Oblique or transverse ramus fracture and ipsilateral anterior sacral ala compression fracture
LC II	Rami fracture and ipsilateral posterior ilium fracture-dislocation (crescent fracture).
LC III	Ipsilateral lateral compression and contralateral APC (windswept pelvis). A common mechanism is rollover vehicle accident or pedestrian vs auto

Vertical Shear (VS)
Vertical shear	Posterior and superior directed force. Associated with the highest risk of hypovolemic shock (63%); mortality rate up to 25%

Additional comments on the Young-Burgess classification:

APC fractures typically result from ‘head on’ collisions, LS fractures from ‘side on’ impacts, and VS fractures from falls from height or ‘head on’ motor vehicle crashes.
The Young-Burgess classification was originally thought to predict the extent of hemorrhage but this has not been supported by subsequent research. The ‘lesser’ fractures can still result in arterial hemorrhage in some cases.

References

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Safety note: This is not a prescription or diagnosis. For severe symptoms, pregnancy danger signs, children with serious illness, chest pain, breathing difficulty, stroke-like weakness, or major injury, seek urgent care.

Which doctor may help?

Start with a registered doctor or the nearest qualified health center.

What to tell the doctor

Write when the problem started and how it changed.
Bring old prescriptions, investigation reports, and current medicines.
Write allergies, pregnancy status, diabetes, kidney/liver disease, and major past illnesses.
Bring one family member if the patient is weak, elderly, confused, or a child.

Questions to ask

What is the most likely cause of my symptoms?
Which danger signs mean I should go to hospital quickly?
Which tests are necessary now, and which can wait?
How should I take medicines safely and what side effects should I watch for?
When should I come for follow-up?

Tests to discuss

Vital signs: temperature, pulse, blood pressure, oxygen saturation
Basic physical examination by a clinician
CBC, urine test, blood sugar, or imaging only when clinically needed

Avoid these mistakes

Do not use antibiotics, steroid tablets/injections, or strong painkillers without proper medical advice.
Do not hide pregnancy, kidney disease, ulcer, allergy, or blood thinner use.
Do not delay emergency care when danger signs are present.

Medicine safety and first-aid guide

This section is for patient education only. It does not replace a doctor, pharmacist, or emergency care.

Safe first steps

Rest, drink safe water, and observe symptoms carefully.
Keep a written note of symptoms, duration, temperature, medicines already taken, and allergy history.
Seek medical care quickly if symptoms are severe, worsening, or unusual for the patient.

OTC medicine safety

For mild pain or fever, ask a registered pharmacist or doctor before using common over-the-counter pain/fever medicines.
Do not combine multiple pain medicines without advice, especially if you have kidney disease, liver disease, stomach ulcer, asthma, pregnancy, or take blood thinners.
Do not give adult medicines to children unless a qualified clinician advises it.

Avoid these mistakes

Do not start antibiotics without a proper medical decision.
Do not use steroid tablets or injections casually for quick relief.
Do not delay emergency care because of home remedies.

Get urgent help if

Severe symptoms, confusion, fainting, breathing difficulty, chest pain, severe dehydration, or sudden weakness need urgent medical care.

Medicine names, dose, and timing must be decided by a qualified clinician or pharmacist after checking age, pregnancy, allergy, other diseases, and current medicines.

For rural patients and family caregivers

Patient health record and symptom diary

Write your symptoms, medicines already taken, test results, and questions before visiting a doctor. This note stays on your device unless you print or copy it.

Doctor to discuss: Doctor / qualified healthcare provider

Tests to discuss with doctor

Basic vital signs: temperature, pulse, blood pressure, oxygen level if needed
Relevant blood, urine, imaging, or specialist tests only after clinical assessment

Questions to ask

What is the most likely cause of my symptoms?
Which warning signs mean I should go to emergency care?
Which tests are really needed now?
Which medicines are safe for my age, pregnancy status, allergy, kidney/liver/stomach condition, and current medicines?

Emergency warning signs such as chest pain, severe breathing difficulty, sudden weakness, confusion, severe dehydration, major injury, or loss of bladder/bowel control need urgent medical care. Do not wait for online information.

Go to emergency care if you notice:

Severe or rapidly worsening symptoms
Breathing difficulty, chest pain, fainting, confusion, severe weakness, major injury, or severe dehydration

Doctor / service to discuss: Qualified healthcare provider; specialist depends on symptoms and examination.

Step 1
Check danger signs first

If danger signs are present, seek emergency care and do not wait for online information.
Step 2
Record the symptom story

Write when symptoms started, severity, medicines already taken, allergies, pregnancy status, and test results.
Step 3
Visit a qualified clinician

A doctor, nurse, or qualified healthcare provider can examine you and decide which tests or treatment are needed.
Step 4
Do only useful tests

Do tests after clinical assessment. Avoid unnecessary tests, random antibiotics, or repeated medicines without diagnosis.
Step 5
Follow up and return early if worse

If symptoms worsen, new warning signs appear, or treatment is not helping, return for review quickly.

Rural patient practical tips

Take a written symptom diary and all previous prescriptions/test reports.
Do not hide medicines already taken, even herbal or over-the-counter medicines.
Ask which warning signs mean urgent referral to hospital.

This roadmap is for education. A real diagnosis and treatment plan requires history, examination, and clinical judgment.

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