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Surgical stabilization of the pelvis following type II anteroposterior compression pelvic injuries (APCII) is based on the assumption that the anterior sacroiliac, sacrospinous, and sacrotuberous ligaments disrupt simultaneously. Recent data on the ligaments contradict this concept. We aimed at determining the mechanisms of ligament failure in APCII computationally. In an individual osteoligamentous computer model of the pelvis, ligament load, and strain were observed for the two-leg stance, APCII with 100-mm symphyseal widening and for two-leg stance with APCII-related ligament failure, and validated with body donors. The anterior sacroiliac and sacrotuberous ligaments had the greatest load with 80% and 17% of the total load, respectively. APCII causes partial failure of the anterior sacroiliac ligament and the pelvis to become horizontally instable. The other ligaments remained intact. The sacrospinous ligament was negligibly loaded but stabilized the pelvis vertically. The interosseous sacroiliac and sacrotuberous ligaments are likely responsible for reducing the symphysis and might serve as an indicator of vertical stability. The sacrospinous ligament appears to be of minor significance in APCII but plays an important role in vertical stabilization. Further research is necessary to determine the influence of alterations in ligament and bone material properties. Keywords: anterior compression pelvic injury; finite element computer study; pelvic biomechanics; sacroiliac joint ligaments; pubic symphysis widening Anteroposterior compression pelvic injuries (APC) or "open book" injuries of the pelvis are most commonly the result of high velocity trauma related to motorcycle or motor vehicle accidents or falls from great heights. 1The Young-Burgess classification system of pelvic injury was developed to predict patient morbidity and mortality and to identify potential needs of non-surgical or operative treatment.1,2 APC are further classified depending on the estimated extent of injury, ranging from mechanically stable APCI via horizontally unstable APCII to completely unstable APCIII disruptions. While, there is a wide consensus that APCII and III should be stabilized surgically, 3,4 the extent of stabilization in all APC is still under discussion.5-7 As a commonly stated postulate, a pubic symphysis widening of more than 25 mm indicates instabilities of the anterior sacroiliac, sacrospinous, and sacrotuberous ligaments 2 (APCII), and therefore requires surgical intervention. However, this value appears to be arbitrary and there is increasing biomechanical 8,9 and clinical evidence 10 that especially the sacrospinous and the sacrotuberous ligaments might not necessarily be injured in APCII and also that sacroiliac joint screws might not provide additional pelvic stability following these cases.11 Moreover, the function of the sacrospinous and sacrotuberous ligaments as pelvic stabilizers is questioned by several authors.12-15 In a previously developed computer model of the pelvic belt, we could prove th...

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This work provides detailed information on the course of the facial vein in relation to neighboring structures. The presented clinically relevant anatomical observations and descriptions of landmarks will serve as helpful information for plastic, reconstructive, and aesthetic surgeons.