Evaluation of using the Anderson-Montesano and the Tuli classifications in pediatric patients with occipital condyle fractures
Abstract 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 cas...
| Main Authors: | , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMC
2021-07-01
|
| Series: | Journal of Orthopaedic Surgery and Research |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s13018-021-02463-w |
| _version_ | 1811186801982832640 |
|---|---|
| author | Ryszard Tomaszewski Jacek Kler Karol Pethe Agnieszka Zachurzok |
| author_facet | Ryszard Tomaszewski Jacek Kler Karol Pethe Agnieszka Zachurzok |
| author_sort | Ryszard Tomaszewski |
| collection | DOAJ |
| description | Abstract 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. |
| first_indexed | 2024-04-11T13:52:33Z |
| format | Article |
| id | doaj.art-34908ac9d9c54e70a0df0bb86e432e59 |
| institution | Directory Open Access Journal |
| issn | 1749-799X |
| language | English |
| last_indexed | 2024-04-11T13:52:33Z |
| publishDate | 2021-07-01 |
| publisher | BMC |
| record_format | Article |
| series | Journal of Orthopaedic Surgery and Research |
| spelling | doaj.art-34908ac9d9c54e70a0df0bb86e432e592022-12-22T04:20:31ZengBMCJournal of Orthopaedic Surgery and Research1749-799X2021-07-011611710.1186/s13018-021-02463-wEvaluation of using the Anderson-Montesano and the Tuli classifications in pediatric patients with occipital condyle fracturesRyszard Tomaszewski0Jacek Kler1Karol Pethe2Agnieszka Zachurzok3Department of Pediatric Traumatology and Orthopedy, Upper Silesian Child Centre in KatowiceDepartment of Pediatric Traumatology and Orthopedy, Upper Silesian Child Centre in KatowiceDepartment of Pediatric Traumatology and Orthopedy, Upper Silesian Child Centre in KatowiceDepartment of Pediatrics and Pediatric Endocrinology, School of Medicine in Katowice, Medical University of SilesiaAbstract 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.https://doi.org/10.1186/s13018-021-02463-wOccipital condyle fracture (OCF)ChildrenTreatmentClassificationsCranio-cervical junction (CCJ) |
| spellingShingle | Ryszard Tomaszewski Jacek Kler Karol Pethe Agnieszka Zachurzok Evaluation of using the Anderson-Montesano and the Tuli classifications in pediatric patients with occipital condyle fractures Journal of Orthopaedic Surgery and Research Occipital condyle fracture (OCF) Children Treatment Classifications Cranio-cervical junction (CCJ) |
| title | Evaluation of using the Anderson-Montesano and the Tuli classifications in pediatric patients with occipital condyle fractures |
| title_full | Evaluation of using the Anderson-Montesano and the Tuli classifications in pediatric patients with occipital condyle fractures |
| title_fullStr | Evaluation of using the Anderson-Montesano and the Tuli classifications in pediatric patients with occipital condyle fractures |
| title_full_unstemmed | Evaluation of using the Anderson-Montesano and the Tuli classifications in pediatric patients with occipital condyle fractures |
| title_short | Evaluation of using the Anderson-Montesano and the Tuli classifications in pediatric patients with occipital condyle fractures |
| title_sort | evaluation of using the anderson montesano and the tuli classifications in pediatric patients with occipital condyle fractures |
| topic | Occipital condyle fracture (OCF) Children Treatment Classifications Cranio-cervical junction (CCJ) |
| url | https://doi.org/10.1186/s13018-021-02463-w |
| work_keys_str_mv | AT ryszardtomaszewski evaluationofusingtheandersonmontesanoandthetuliclassificationsinpediatricpatientswithoccipitalcondylefractures AT jacekkler evaluationofusingtheandersonmontesanoandthetuliclassificationsinpediatricpatientswithoccipitalcondylefractures AT karolpethe evaluationofusingtheandersonmontesanoandthetuliclassificationsinpediatricpatientswithoccipitalcondylefractures AT agnieszkazachurzok evaluationofusingtheandersonmontesanoandthetuliclassificationsinpediatricpatientswithoccipitalcondylefractures |