[Legal assessment of fractures and ruptures of the pelvis].

Since it is very difficult to arrive at a complete picture of the very varied effects of fractures and ruptures in the pelvic region, the few studies that have so far dealt with the assessment of injuries to the pelvic girdle have been unable to develop any uniform guidelines. An analysis of the clinical, radiological and in particular CT studies that have been published to date shows that there is a well-defined relationship between clinical and radiological symptomatology. This allows cases to be assessed expertly and objectively. Where there are unstable pelvic girdle fractures, follow-up examinations can use the extent of symphyseal diastasis and the dislocation of one or both halves of the pelvis in relation to the sacrum as a yardstick to assess the effects of injury on the posterior pelvic girdle and their consequences - effects which would otherwise be difficult to detect. Only where there are symphyseal diastases of more than 15 mm with degenerative alterations of the sacroiliac joint and permanent dislocation of one half of the pelvis does an impairment of earning capacity of 20% apply. Impairment-of-earning-capacity rates of 30-40% are appropriate in cases with completely unstable pelvic girdle fractures involving dislocation of both halves of the pelvis and posttraumatic arthritis in the sacroiliac joints. All other pelvic girdle or iliac wing fractures qualify for a maximum 10% reduction in earning capacity, even if the symphysis has become rigid.