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. 2020 Jul-Sep;11(3):173-179.
doi: 10.4103/jcvjs.JCVJS_100_20. Epub 2020 Aug 14.

Clinical relevance of occipital condyle fractures

Stijn J van der Burg  1 , Martin H Pouw  1 , Monique Brink  2 , Helena Dekker  2 , Henricus P M Kunst  3   4 , Allard J F Hosman  1
Affiliations

Clinical relevance of occipital condyle fractures

Stijn J van der Burg et al. J Craniovertebr Junction Spine. 2020 Jul-Sep.

Abstract

Context: No consensus about classification, treatment, and clinical relevance of occipital condyle fractures (OCFs) exists.

Aims: The aim of the study was to determine radiological, clinical, and functional outcome of OCFs and thereby determine its clinical relevance.

Settings and design: This was a retrospective analysis of a prospective follow-up study.

Materials and methods: From May 2005 to May 2008, all OCFs were included from a Level-1 trauma center. Patient files were reviewed for patient and fracture characteristics. Fracture classification was done according to the Anderson criteria. Clinical outcome was assessed by completing two questionnaires, radiological outcome by computed tomography imaging, and functional outcome by measuring active cervical range of motion using a Cybex EDI-320.

Statistical analysis used: A Fisher's exact Test was used in categorical variables and a one-sample t-test for comparing means of active cervical range of motion in occipital fracture patients with normal values. An independent samples t-test was carried out to compare the means of groups with and without accompanying cervical fractures for each motion.

Results: Thirty-nine patients were included (4 type I, 16 type II, and 19 type III). Twenty-seven patients completed follow-up, of whom 26 were treated conservatively. Fracture healing was established in 25 of 28 fractures at a median follow-up of 19 months. Eleven patients had none to minimal pain or disability at follow-up, 12 had mild, and two had moderate pain or disability on questionnaires. No statistically significant difference in active cervical range of motion was identified comparing means stratified for accompanying cervical fractures.

Conclusions: Conservatively treated patients with an OCF generally show favorable radiological and clinical outcome.

Keywords: Fracture healing; neck disability index; neck pain and disability scale; occipital condyle fractures; range of motion.

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Conflict of interest statement

There are no conflicts of interest.

Figures

Figure 1
Figure 1
Schematic coronal view of Anderson et al. classification system. FLTR Type I; Type II; Type III. (A) Alar ligament. (B) Basilar skull. (OC) Occipital condyle. (C1) Atlas. (C2) Axis. (D) Dens. (H) Hypoglossal canal
Figure 2
Figure 2
Flowchart of the study design
See this image and copyright information in PMC

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