Case Studies
A Novel Approach to Pelvic Fracture Fixation 2
“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.
Unstable spinopelvic dissociation with contraindication to lumbopelvic fixation1
Patient History:
- 62 yo male with COPD and 1 month old sacral U-type fracture after motorcycle crash (Figs. 1 and 2)
- Excruciating pain with any attempt at mobilizing Transferred from outside hospital after developing multiple abscesses around the pelvis and lumbar spine Lumbopelvic fixation was contraindicated due to the location of paraspinal abscesses
- Comminution and displacement of the right side component of his sacral U-type fracture significantly decreased the osseous corridor for placement of trans-sacral style screw in S1 requiring an iFuse TORQ® implant to provide sufficient fixation
Fig. 1: Axial CT scan demonstrating bilateral sacral fracture with displacement.
Fig. 1: Axial CT scan demonstrating bilateral sacral fracture with displacement.
Fig. 2: Sagittal CT scan demonstrating significant displacement of sacral U fracture.
Fig. 2: Sagittal CT scan demonstrating significant displacement of sacral U fracture.
IntraOp:
His pelvic abscesses were debrided and washed (lateral window) and antibiotic beads were placed followed by percutaneous placement of bilateral ilio-sacral style S1 implants. Intraoperative CT scan was performed after placement of 3.2 mm guidewires to confirm safe path of placement for iFuse TORQ implants in the setting of poor visualization of the foramen (Fig. 3). Bilateral 13.5mm iFuse TORQ implants were placed and the patient was allowed weightbearing as tolerated for activities of daily living at his home (Fig. 4).
Fig. 3: CT scan demonstrating safe path for implant placement.
Fig. 3: CT scan demonstrating safe path for implant placement.
Fig. 4: Final fluoroscopic outlet demonstrating bilateral 13.5mm implants.
Fig. 4: Final fluoroscopic outlet demonstrating bilateral 13.5mm implants.
Surgical Treatment:
Immediate postoperative CT scan demonstrate safe placement of implants (Figs. 5A and 5B).3 AP and standing lateral sacral view at 3 months follow-up. Callous formation noted on the lateral radiograph (Figs. 6A and 6B).
Clinically, the patient is ambulating comfortably and is not requiring opioids.4
1,2Patient results may vary.
3SI-BONE Post Market Surveillance May 2023
4Pain 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.