Case Studies
A Novel Approach to Pelvic Fracture Fixation
“Unique implants with specific indications”
*Consultant for SI-BONE Inc.
- Provider
- Reza Firoozabadi, M.D., M.A.*
- Speciality
- Orthopaedic Trauma Surgeon. Harborview Medical Center and a UW Associate Professor of Orthopedics and Sports Medicine
- Facility
- Harborview Medical Center
- Bio
-
Medical School: Boston University School of Medicine
Residency: University of California, San Francisco
Fellowship: Harborview Medical Center/University of Washington Dr. Firoozabadi is a board-certified orthopedic surgeon whose interests focus on both the clinical and technical aspects of orthopaedic trauma surgery and the injured patient. He has a specific interest in pelvic and acetabular surgery, both from a clinical as well as a research standpoint.
Fracture Fixation of U-Type Sacral Fragility Fracture1
Patient History:
- 75 yo female with inability to mobilize 6 weeks after a fall
- Minimal improvement in posteriorly-based pain and can only mobilize from bed to a chair at rehab facility
- CT scan confirmed U-type fracture at 6 weeks (Figs. 1 and 2)
- S1 osseous corridor would not accomodate trans-sacral style screws therefore decision was made for bilateral ilio-sacral style implants
- Family was not interested in additional lumbopelvic fixation due to the patient’s thin soft tissue envelope, and the posterior spinal instrumentation would most likely be symptomatic
Fig. 1: Axial CT scan demonstrating bilateral nondisplaced sacral fractures.
Fig. 1: Axial CT scan demonstrating bilateral nondisplaced sacral fractures.
Fig. 2: Sagittal CT scan demonstrating transverse component at the junction of S1 and S2 making this a sacral U-type of fracture.
Fig. 2: Sagittal CT scan demonstrating transverse component at the junction of S1 and S2 making this a sacral U-type of fracture.
Surgical Treatment:
8.0mm ilio-sacral style screw was placed across the fracture with poor purchase, most likely due to patient being severely osteopenic. Surgical options were to add percutaneous lumbopelvic fixation or utilize a “rescue screw” (Fig. 3).
Surgeon elected to remove the screw and replace with a 11.5mm iFuse TORQ® implant which had excellent purchase. Another 11.5mm iFuse TORQ implant was placed on the contralateral side to allow immediate weightbearing. No implants placed in S2 since the fracture was cranial to S1/S2 junction (Fig. 4).
PostOp:
Outlet radiograph demonstrating placement of bilateral 11.5 iFuse TORQ implants (Fig. 5).
Patient was able to immediately weight-bear postoperative day 1. Patient had marked improvement in posterior pelvic pain. She had slight discomfort bilaterally at her surgical sites. She was able to be discharged on postoperative day 2 to her home.3
1,2Patient results may vary
3Pain and disability improvement consistent with early SAFFRON (NCT05426356) trial outcomes. SI-BONE data on file.
Healthcare professionals should refer to the Instructions For Use for indications, contraindications, warnings, and precautions at https://si-bone.com/label.
There are potential risks associated with iFuse procedures. They may not be appropriate for all patients and all patients may not benefit.
For information about the risks, visit https://si-bone.com/risks.