Tehran University of Medical Sciences Journal of Orthopedic and Spine Trauma 2538-2330 12 3 2026 07 16 135 8 Ali Yeganeh Associate Professor, Department of Orthopedics, Bone and Joint Reconstruction Research Center, School of ‎Medicine, Iran University of Medical Sciences, Tehran, Iran Shayan Amiri Assistant Professor, Department of Orthopedic Surgery, Shahadaye Haftome Tir Hospital, School of Medicine, Iran University of Medical Sciences, Tehran, Iran Mahan Babaei Students' Scientific Research Center, Center for Orthopedic Transdisciplinary Applied Research (COTAR), Tehran University of Medical Sciences, Tehran, Iran Mehdi Komijani Assistant Professor, Department of Orthopedics, Center for Orthopedic Transdisciplinary Applied Research (COTAR), School of Medicine, Tehran University of Medical Sciences, Tehran, Iran 2025 11 14 2026 05 31 Background: Dislocations of the bilateral sacroiliac (SI) joint are serious injuries. It is extremely rare to experience SI joint dislocation without fracture or disruption of the anterior pelvic ring. Even though SI dislocations can be fixed via several different methods, the surgical technique should be tailored to everyone based on the patient's injuries. The treatment of these fractures with operative intervention remains difficult because of the possibility of other injuries associated with the fractures. Only three cases of this type of injury treated with open reduction and internal fixation (ORIF) have been reported in the literature. Case Report: A 15-year-old girl presented with high-energy trauma. In the left hand, she had a fracture-dislocation of the wrist; in the right ankle, she had a pilon fracture and a calcaneus fracture. Her pelvis had a bilateral SI dislocation without a fracture in the pelvic ring. After hemodynamic stabilization, surgical management was performed for the wrist fracture-dislocation, as well as the pilon and calcaneus fractures. Four days later, the bilateral SI dislocations were fixed. We performed closed reduction and internal fixation (CRIF) due to the patient's situation and the high risk of infection. At the last follow-up, the fracture had united, and the patient experienced no discomfort in performing her daily activities. Conclusion: While the optimal method for fixing this injury is unclear, ORIF is the conventional approach for similar cases. However, in this case, CRIF was chosen due to disadvantages associated with ORIF, such as nerve damage, swelling, incomplete bone healing, increased pressure, blood clots, and our patient’s situation. https://jost.tums.ac.ir/index.php/jost/article/view/735 https://jost.tums.ac.ir/index.php/jost/article/download/735/476