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. 2012 Feb;21(2):289-94.
doi: 10.1007/s00586-011-1963-7. Epub 2011 Aug 11.

Occipital condyle fractures. Prospective follow-up of 31 cases within 5 years at a level 1 trauma centre

Franz Josef Mueller  1 , Bernd Fuechtmeier, Bernd Kinner, Michael Rosskopf, Carsten Neumann, Michael Nerlich, Carsten Englert
Affiliations

Occipital condyle fractures. Prospective follow-up of 31 cases within 5 years at a level 1 trauma centre

Franz Josef Mueller et al. Eur Spine J. 2012 Feb.

Abstract

Purpose: Prospective investigation of incidence and outcome of occipital condyle fractures (OCF) in a level 1 trauma centre.

Methods: Over a period of 5 years, we prospectively recorded all cases of OCF, and performed a 1-year post-injury radiological and clinical follow-up using CT imaging, SF-36 and Neck Disability Index, respectively.

Results: A total of 31 patients with OCF were identified. Based on a total of 2,616 CT scans that had been performed during this period, the incidence was 1.19%. There were 27 unilateral and 4 bilateral OCFs. Furthermore, 3 out of 31 patients (9.7%) were additionally diagnosed with atlanto-occipital dislocation (AOD), one of which was dorsally stabilised in a surgical procedure. All other patients were treated conservatively. 5 out of 31 patients (16.1%) died due to the severity of associated injuries. 22 out of 31 patients (70.9%) were prospectively followed-up for 1 year after trauma. During this period, CT imaging showed bony consolidation of fractures in all cases except for one, with no evidence of secondary dislocation or nonunion. Evaluation of the Neck Disability Index showed moderate disability. The SF-36 questionnaire showed an impaired quality of life in all areas; however, these were determined by associated injuries and independent of the type of fracture.

Conclusions: Both unilateral and bilateral OCFs represent a stable injury regardless of the type of fracture. If AOD has been diagnosed in addition, it requires surgical stabilisation-independent of the OCF-and it is a significant predictor for poor outcomes. The patients quality of life 1 year after trauma has not been affected by the OCF, but by the overall pattern of the injury and by comorbidities. Based on our results, we introduce a new, simple and practical classification for OCFs.

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Figures

Fig. 1
Fig. 1
a Coronal CT image: OCF type 1 according to Anderson/Montesano [5], left side.b Coronal CT image: OCF type 1, left side, 1 year post-injury
Fig. 2
Fig. 2
a Axial CT image: OCF type 3, according to Anderson/Montesano [5], left side. b Axial CT image: OCF type 3, left side, 1 year post-injury
Fig. 3
Fig. 3
a Coronal CT image: bilateral OCF. b Coronal CT image: bilateral OCF, 1 year post-injury
Fig. 4
Fig. 4
a Coronal CT image: OCF type 3, according to Anderson/Montesano [5], left side, AOD right side. b Sagittal CT image: OCF type 3, left side, c Sagittal CT image: OCF type 3, left side, 1 year post-injury after cranio-cervical instrumentation
See this image and copyright information in PMC

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