Case of a female patient (42 years old) with right sacroiliac joint instability (C1 Tile injury) and opening of the pubic symphysis following suicidal attempt by fall from height (picture on the left). The patient was initially treated with reduction of the vertical shear and double plate fixation of the pubic symphysis using (anterior approach) and this was followed after 3 days by percutaneous CT-guided screw fixation of the sacroiliac joint (picture on the right).