Case of a male patient (49 years old) with C1 Tile fracture, left ileopubic rami fracture and left S-I joint instability following a motorbike accident (top three pictures: AP X-ray view and pelvis 3D CT reconstruction). The patient was initially treated with S-I joint reduction and fracture reduction with plate and screws by anterior approach (bottom-left picture). This was followed (4 days following the initial surgical procedure) by surgical stabilization of the S-I joint with two percutaneous CT-guided cannulated screws within S1 and S2 vertebral body (sagittal and coronal CT-scan views).