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Observational Study
. 2021 Nov 29:48:e20213024.
doi: 10.1590/0100-6991e-20213024. eCollection 2021.

Observational study of patients with occipital condyle fracture at a brazilian referral trauma center

[Article in English, Portuguese]
Andrew Vinícius DE Souza Batista  1 , Guilherme Brasileiro Aguiar  1 , Priscilla Bennett  1 , Márcia Ramos Umigi  1 , José Carlos Esteves Veiga  1
Affiliations
Observational Study

Observational study of patients with occipital condyle fracture at a brazilian referral trauma center

[Article in English, Portuguese]
Andrew Vinícius DE Souza Batista et al. Rev Col Bras Cir. .

Abstract
in English, Portuguese

Objective: to evaluate the clinical-epidemiological characteristics, treatment, and evolution of patients with occipital condyle fracture (OCF) at one of the largest referral trauma centers in Latin America.

Methods: this was a retrospective observational study of OCF identified from trauma cases admitted between December 2011 and December 2019 by the neurosurgery team at a Type 3 trauma center.

Results: a total of twenty-eight occipital condyle fractures were identified in twenty-six patients. The incidence was less than 0.2% per year and more common in male patients (4:1 ratio) involved in traffic accidents. The mean age was 42.08 years. Anderson and Montesano type II and Tuli type 1 were the most frequent (67.9% and 89.3%, respectively) and no case presented C0-C1-C2 instability. All patients were treated with a cervical collar for 3 to 6 months. About 65% of the patients exhibited good progression (Glasgow Outcome Scale equal to 4), and the severity of traumatic brain injury was the main determinant for negative outcomes.

Conclusion: the findings of this study are in accordance with available literature data. The use of external stabilization with a cervical collar is reinforced for the treatment of stable lesions, even when these are bilateral. Assessment of the patients' follow-up results in the studied sample may contribute with useful information for the treatment of occipital condyle fractures.

Objetivo:: avaliar o perfil clínico-epidemiológico, o tratamento e a evolução de pacientes com fraturas do côndilo occipital (FCO) em um dos maiores centros especializados em trauma na América Latina.

Método:: este é um estudo observacional retrospectivo de FCO identificadas em casos de trauma que foram atendidos no período de Dezembro de 2011 a Dezembro de 2019 pela equipe de trauma de centro de trauma Tipo 3.

Resultados:: um total de vinte e oito fraturas do côndilo occipital foram identificadas em 26 pacientes. A incidência foi inferior a 0.2% ao ano e mais comum em pacientes do sexo masculino (proporção 4:1) envolvidos em acidentes de trânsito. A idade média foi de 42.08 anos. O Tipo II de Anderson e Montesano e o Tipo 1 de Tuli foram os mais frequentes (67.9% e 89.3%, respectivamente) e nenhum caso teve instabilidades C0C1C2. Todos os pacientes foram tratados com colar cervical por período de 3 a 6 meses. Cerca de 65% dos pacientes apresentaram boa evolução (Escala de Resultados de Glasgow maior ou igual a 4), e a gravidade da lesão cerebral foi o principal determinante para os resultados negativos.

Conclusão:: os achados deste estudo são similares a dados disponíveis na literatura. O uso de colar cervical para estabilização externa é reforçado para o tratamento de lesões estáveis, mesmo quando bilaterais. A avaliação dos resultados do acompanhamento dos pacientes na amostra estudada pode contribuir com informações úteis para o tratamento de fraturas de côndilo occipital.

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Conflict of interest statement

Conflict of interest: no.

Figures

Figure 1
Figure 1. Examples of occipital condyle fractures. The first line shows the axial (A) and coronal (B) sections of a patient with A&M Type I OCF on the right side (Tuli Type I). The second line (C and D), in turn, shows a linear occipital fracture on the right side extending to the ipsilateral occipital condyle (A&M Type II, Tuli Type I). The last line (E and F) shows an example of avulsion of an occipital condyle fragment (A&M Type III, Tuli Type IIA). Fractures are demonstrated by arrows. OCF: fracture of the occipital condyle; A&M: Anderson and Montesano. Source: Authors.
Figure 2
Figure 2. Distribution of patients by age group.
See this image and copyright information in PMC

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