Occipital Condyle Fractures in Adolescents

Abstract

Background: Occipital condyle fractures are rare injuries of the cranio-cervical junction seen more often in adults than in children. They are best diagnosed with CT of the cranio-cervical junction. Treatment depends on the morphology and stability of the fracture. The aim of the present paper was to present cases of occipital condyle fractures treated at our Department, review the literature, and stress the importance of MRI studies in the diagnostic work-up of these injuries.

Material and methods: Our retrospective study involved a group of 3 female patients (mean age was 16.3 years) with occipital condyle fractures diagnosed/treated at our Department. We assessed the cause and type of fracture, additional damage, available classification systems, treatment methods, outcomes and complications.

Results: Mean follow-up period was 16 (10-22) months. We achieved good clinical outcomes (NDI scores) in all the patients. In one patient, a follow-up MRI scan revealed the presence of a clinically silent post-traumatic epidural meningeal cyst at the C2-C6 level, anterior to the spinal cord.

Conclusions: CT of the cranio-cervical junction is the best method of diagnosing occipital condyle fractures. 2. The choice of an appropriate treatment method is decisively based on the assessment of the morphology and stability of the fracture in a CT/MRI scan rather than on the fracture type alone. 3. There is no noticeable difference between the usefulness of the classification system developed by Anderson and Montesano and that according to Tuli et al. 4. In our opinion, the system of occipital condyle fracture classification proposed in 2012 does not seem superior in everyday clinical practice. 5. The use of the halo-vest is a good method of treating unstable occipital condyle fractures. 6. Early diagnosis and appropriate treatment of cranio-cervical junction fractures make it possible for the fracture to heal without severe clinical sequelae.