Bilateral Occipital Condyle Fracture: Report of Two Cases

Schrödel, Markus; Kestlmeier, R; Trappe, Anna

doi:10.1055/s-2002-31571

Cited by 4 publications

(4 citation statements)

References 14 publications

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“…Thus, even this fracture may be considered stable (while taking into account the small number of cases in our study). Other authors [4,12] also consider immobilisation of bilateral OCFs to be sufficient using conservative measures such as a cervical collar. They did neither report any evidence of secondary dislocation nor instability.…”

Section: Discussionmentioning

confidence: 99%

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

et al. 2011

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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 postinjury 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 atlantooccipital 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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Section: Discussionmentioning

confidence: 99%

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

et al. 2011

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“…The occipital condyle has close proximity to the hypoglossal canal and jugular foramen, which could affect the nerves IX, X, XI, and XII, besides brainstem causing medulla compression and therefore respiratory distress. 5 OCF occurs due to trauma with high kinetic energy transmission, generally in motor vehicle accidents. The exact trauma mechanism is not known, but many researchers indicate neck hyperextension associated with vertical force above craniocervical junction as a possible cause.…”

Section: Discussionmentioning

confidence: 99%

Occipital Condyle Fractures in Traumatic Brain Injury—A Review

et al. 2015

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Palavras-Chave► côndilo ► fratura de côndilo occipital ► trauma cranioencefálico Resumo É bem estabelecido que o diagnóstico da fratura de côndilo occipital tem aumentado nas últimas décadas, provavelmente devido à disponibilidade e ao uso comum da tomografia computadorizada durante a investigação do trauma craniano, além da maior gravidade dos mecanismos de trauma. Por causa da baixa especificidade da apresentação clínica, e também pelo pouco conhecimento sobre o mecanismo de lesão, o diagnóstico desta condição é um desafio para neurocirurgiões. A abordagem terapêutica destes pacientes é baseada em estudos com baixa casuística e em relatos de caso. Uma revisão sobre este tema foi realizada a fim de discutir alguns aspectos controversos sobre o manejo da fratura de côndilo occipital. As fraturas de côndilo occipital são eventos raros, entretanto podem relacionar-se à alta morbidade em pacientes que sofreram trauma encefálico. Alguns sintomas, como intensa dor cervical, podem estar associados com esta fratura; portanto, paciente com suspeita de fratura de côndilo occipital deve ser submetido a investigação radiológica detalhada da região. O diagnóstico precoce desta fratura permite investigação apropriada, minimizando a chance de sequelas. Keywords► condyle ► occipital condyle fracture ► traumatic brain injury Abstract It is well established that diagnoses of occipital condyle fracture have increased in past decades, probably because of the availability and common use of computed tomography for investigating traumatic brain injuries, as well as the major seriousness of trauma mechanism. Because of the low specificity of clinical presentation besides the lesion mechanism not well known, this condition is a diagnostic challenge for neurosurgeons. Therapeutic approaches of these patients are based on studies with low samples and case reports. A review of this theme was performed objecting to discuss some

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“…[1,4,6] AOİ bulunmayan iki taraflı OKK olguları benzer şekilde stabil olarak kabul edilerek servikal eksternal immobolizasyon tedavi edilebilir. [2,9] Bununla birlikte, Dashti ve ark., [10] inferior klivus kırığının eşlik ettiği iki taraflı OKK olan çoklutravmalı bir olguda Halo yelek kullanı-mı ile kemik iyileşmenin sağlandığını bildirmişlerdir. OKK'ya AOİ'nin eşlik etme riski %9.7'dir (Mueller ve ark.).…”

Section: Discussionunclassified