Isolated condylar fractures diagnosed by post mortem computed tomography

Borowska-Solonynko, Aleksandra; Prokopowicz, Victoria; Samojłowicz, Dorota; Brzozowska, Małgorzata; Żyłkowski, Jarosław; Lombarski, Leszek

doi:10.1007/s12024-019-00104-7

Cited by 5 publications

(11 citation statements)

References 22 publications

(27 reference statements)

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“…OCF occurs in 1% to 3% of cervical spine injuries [8,17], and the associated mortality rate is high (8.3%-16.0%) [9]. OCF has frequently been detected in post-mortem examinations, including the first report of OCF by Bell in 1817 [1,8,17,18]. OCF occurs mainly in adolescents and young male adults [19], which agrees with our observation.…”

Section: Discussionsupporting

confidence: 90%

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Treatment of Unstable Occipital Condylar Fractures in Children—A STROBE-Compliant Investigation

Tomaszewski

Gap²,

Lucyga³

et al. 2021

Medicina

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Background and objectives: Occipital condyle fractures (OCF) occur rarely in children. The choice of treatment is based on the Anderson–Montesano and Tuli classification systems. We evaluated the outcome of unstable OCF in children and adolescents after halo-vest therapy. Materials and Methods: We treated 6 pediatric patients for OCF, including 3 patients (2 girls, 1 boy) with unstable OCF. Among the 3 patients with unstable OCF, 2 patients presented with an Anderson–Montesano type III and Tuli type IIB injury, while 1 patient had an Anderson–Montesano type I fracture (Tuli type IIB) accompanied by a C1 fracture. On admission, the children underwent computed tomography (CT) of the head and cervical spine as well as magnetic resonance imaging (MRI) of the cervical spine. We treated the children diagnosed with unstable OCF with halo-vest immobilization. Before removing the halo vest at the end of therapy, we applied the CT and MRI to confirm OCF consolidation. At follow-up, we rated functionality of the craniocervical junction (CCJ) based on the Neck Disability Index (NDI) and Questionnaire Short Form 36 Health Survey (SF-36). Results: All children achieved OCF consolidation after halo-vest therapy for a median of 13.0 weeks (range: 12.5–14.0 weeks). CT and MRI at the end of halo-vest therapy showed no signs of C0/C1 subluxation and confirmed the correct consolidation of OCF. The only complication associated with halo-vest therapy was a superficial infection caused by a halo-vest pin. At follow-up, all children exhibited favorable functionality of the CCJ as documented by the NDI score (median: 3 points; range: 3–11 points) and SF-36 score (median: 91 points; range: 64–96 points). Conclusions: In our small case series, halo-vest therapy resulted in good mid-term outcome in terms of OCF consolidation and CCJ functionality. In pediatric patients with suspected cervical spine injuries, we recommend CT and MRI of the CCJ to establish the diagnosis of OCF and confirm stable fracture consolidation before removing the halo vest.

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Section: Discussionsupporting

confidence: 90%

“…In all these patients, a decision between conservative or surgical treatment has to be taken. We agree with other authors that the most important criterion for decision making regarding the type of treatment is accurate assessment of fracture stability [1,4,18,32].…”

Section: Conservative Treatment Options For Ocfsupporting

confidence: 90%

Treatment of Unstable Occipital Condylar Fractures in Children—A STROBE-Compliant Investigation

Tomaszewski

Gap²,

Lucyga³

et al. 2021

Medicina

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“…OCFs are usually the result of high-energy trauma [4,11], especially road traffic injuries, as confirmed by our patient series. It is worth noting that the second cause of OCFs in our patients was extreme sports accidents.…”

Section: Discussionsupporting

confidence: 81%

“…The other patients were treated with a Minerva collar. The halo-vest stabilization was maintained for 13.1 weeks (12.5-14) and a cervical collar for 11.3 weeks (11)(12). During the treatment, the patients were monitored by CT or MR imaging.…”

Section: Methodsmentioning

confidence: 99%

“…After confirming the satisfactory alignment of the injured bone fragments, the patients were discharged from the unit with the recommendation of a conscientious lifestyle and observation for the occurrence of distressing symptoms. The CT of cranio-cervical junction (CCJ) was performed in all patients at the end of the treatment, in patients treated with the halo-vest after 13 weeks (11)(12)(13)(14), and with the cervical collar after 11 (9)(10)(11)(12) weeks.…”

Section: Methodsmentioning

confidence: 99%

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Evaluation of using the Anderson-Montesano and the Tuli classifications in pediatric patients with occipital condyle fractures

Tomaszewski

Kler²,

Pethe³

et al. 2021

J Orthop Surg Res

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Background Occipital condyle fractures (OCFs) in patients before 18 years of age are rare. Classifications of OCF are based on the CT images of the cranio-cervical junction (CCJ) and MRI. The Anderson-Montesano and Tuli classifications are the types which are most commonly used in these cases. Classification of OCFs allows the implementation of OCF treatment. The aim of this study was to evaluate the effectiveness of using the OCF classification in pediatric patients based on the analysis of our own cases. Methods During the years 2013–2020, 6 pediatric patients with OCFs, aged 14–18, have been treated. Two patients with unstable fracture III according to Anderson-Montesano and IIB according to Tuli were treated with the halo-vest. Additionally, one patient presenting neurological symptoms and with an associated C1 fracture was qualified for the halo-vest stabilization as well. The other patients were treated with a Minerva collar. We evaluated the results 6 months after completing the OCF treatment using the Neck Disability Index (NDI) and SF-36 questionnaires. Confidence intervals for the mean values were verified using the MeanCI function (from the R library DescTools) for both classical and bootstrap methods. Results Based on NDI results, we have obtained in our patients an average of 4.33/45 points (2–11) and 9.62% (4.4–24.4). Based on the SF-36 questionnaire, we obtained an average of 88.62% (47.41–99.44). Conclusion The Anderson-Montesano and Tuli’s classifications of OCF can be used to assess the stability of OCF in adolescents, but both classifications should be used simultaneously. CT and MR imaging should be used in diagnosing OCFs, whereas CT allows assessing therapeutic outcomes in OCF.

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Occipital condyle fracture—A rare but severe injury in cranial fracture patients

Lassila

Puolakkainen

Brinck

et al. 2021

Journal of Cranio-Maxillofacial Surgery

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Isolated condylar fractures diagnosed by post mortem computed tomography

Cited by 5 publications

References 22 publications

Treatment of Unstable Occipital Condylar Fractures in Children—A STROBE-Compliant Investigation

Treatment of Unstable Occipital Condylar Fractures in Children—A STROBE-Compliant Investigation

Evaluation of using the Anderson-Montesano and the Tuli classifications in pediatric patients with occipital condyle fractures

Occipital condyle fracture—A rare but severe injury in cranial fracture patients

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