Saving the Shattered

Bad Breaks, Great Outcomes

A freak boating accident left Nicole Azevedo with a fractured pelvis, but a high-tech surgical repair has her looking forward to summer on the water.

What happens when bones aren’t just broken, they’re shattered? Crushed pelvises, high-energy fractures to the knee, elbow and ankle joints, and even pediatric fractures— these are severe injuries that require complex surgical repair by highly trained orthopedists using the most advanced surgical innovations.

It wasn’t all that long ago these cases had to be referred out of Solano County for treatment. But not any-more, said Cornelis Elmes, M.D., a NorthBay Healthcare orthopedic surgeon. “We not only keep the most complex cases here at NorthBay Medical Center, it’s not unusual for us to receive patients from other hospitals.”

As a Level II Trauma Center, NorthBay Medical Center is home not only to a cadre of orthopedic specialists but also surgical suites outfitted with the latest equipment best suited to repair even the most complex cases, according to Heather Venezio, Trauma program director. It’s a combination that has earned the NorthBay Orthopedics team a reputation for excellence in the region, she added.

Nicole Azevedo, 30, of Fairfield, learned first-hand how fortunate it could be to have top-flight care so close to home. “I went from experiencing the most horrific pain and being scared I was never going to walk again, to catching a football in the street with my family just a few months later,” she says.

Nicole suffered a high-impact injury, in a rather unique accident. “I broke my pelvis on an inner tube. When people ask what happened, they can’t believe it.”

It was a freak accident, she explained. Last summer she and her boyfriend were inner tubing on Lake Berryessa behind her sister’s boat when—with arms linked—they suddenly hit a large wake and were flung up in the air.

“I came down, hit the inner tube, and then my boyfriend came down with his fully body weight on my back. I heard a pop and the pain sucked all the air out of me.”

Nicole fell in the water and, because she couldn’t move her legs, immediately struggled to keep her head above the waves. “The pain in my legs and groin was unbelievable. It was horrifying. I was choking on the water.”

Friends struggled to delicately lift Nicole into the boat and slowly made their way back to the dock. “My sister, a nurse, called 9-1-1 and the paramedics were waiting for us. I asked them to take me to NorthBay Medical Center, because it was close to my home.”
Only later did she learn that her decision was right for so many other reasons.

“A relative of mine is a surgical nurse at a medical facility in Roseville, and my family wanted me transferred up there. But then they looked up Dr. Elmes, who was treating me in the NorthBay Emergency Department, and they said, ‘no, stay right there.’”

With the O-arm, surgeons can fix large fractures using only screws inserted through very small incisions.

Dr. Elmes has many years of experience reassembling shattered bones, having worked at Level I and Level II trauma centers in New York, Florida and California. He joins a team well experienced in treating not only pelvic fractures, but periarticular fractures—a break around or very near a joint like an elbow, ankle or knee—as well as open fractures, hard-to-treat bone infections and even pediatric fractures. The team is skilled in replacing knees, hips, shoulders and soon, ankles.

He and his team work in surgical suites that are equipped with the latest in surgical equipment, such as a Stealth Navigator for computer-assisted surgery, and an O-arm Surgical Imaging System that uses X-rays to allow the surgeon to more accurately navigate to the exact point of injury.

With the O-arm, surgeons can fix large fractures using only screws inserted through very small incisions, frequently in less time and with greater precision and accuracy.

And that’s exactly the tool Dr. Elmes used to stabilize Nicole’s fractured pelvis with a single screw.

After surgery, Nicole used crutches to keep weight off her hips. “I now only have occasional soreness. And, I have only have the tiniest of incision scars,” she said.

“This whole process was made so much easier because all my after-care was just down the street,” she added. “Dr. Elmes and the entire orthopedics staff made my recuperation so easy. They had a walker delivered to my home even before I was discharged.”

While the injury was a horrible experience, Nicole is gratified by the outcome. “I was sure I would never walk again. And now I’m not only pain free, but working and running and playing with my daughter.”

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