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Review
. 2024 Feb 13;18(2):216-228.
doi: 10.1177/18632521241229301. eCollection 2024 Apr.

Occipital condyle fracture in the pediatric population: A management algorithm and systematic review

Mary M Morcos  1   2 , David S Liu  1   3 , Alexander R Farid  1 , Pokmeng See  4 , Grant D Hogue  1   5
Affiliations
Review

Occipital condyle fracture in the pediatric population: A management algorithm and systematic review

Mary M Morcos et al. J Child Orthop. .

Abstract

Purpose: This study aims to develop an accessible stepwise management algorithm for pediatric presentations of occipital condyle fractures (OCFs) based on a systematic review of the published literature regarding diagnostic evaluation, treatment, and outcomes.

Methods: A systematic review of the literature was conducted on PubMed to locate English language studies reporting on the management of pediatric OCFs. Data extraction of clinical presentation, management strategies, imaging, and treatment outcome was performed.

Results: A total of 15 studies reporting on 38 patients aged 18 years and younger presenting with OCFs were identified. Loss of consciousness (LOC), depressed level of consciousness, neck pain, decreased neck range of motion (ROM), and cranial nerve injury were the most common presenting symptoms. Diagnostic imaging included radiographs, computed tomography (CT) scans, magnetic resonance imaging (MRI), and functional radiographs to assess cervical stability. Treatment options varied and included soft collar, hard collar, and halo vest. All studies resulted in a complete healing of the OCF, with resolution of associated pain.

Conclusion: The proposed treatment algorithm suggests a framework for the management of pediatric OCFs based on the available evidence (levels of evidence: 3, 4). This review of the literature indicated that a stepwise approach should be utilized in the management of isolated pediatric OCFs.

Keywords: Occipital condyle fracture; children; craniocervical junction; management algorithm; pediatrics.

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Conflict of interest statement

The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Figures

Figure 1.
Figure 1.
PRISMA selection of studies.
Figure 2.
Figure 2.
Management Algorithm of Pediatric Occipital Condyle Fracture.
See this image and copyright information in PMC

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