Fractures of the occipital condyle clinical spectrum and course in eight patients
Introduction: Occipital condyle fractures (OCFs) are considered to be rare injuries. OCFs are now diagnosed more often because of the widespread use of computed tomography. Our aim is to report the incidence, treatment and long term outcome of 8 patients with OCFs. Materials and Methods: All patient...
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| Format: | Article |
| Language: | English |
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Wolters Kluwer Medknow Publications
2013-01-01
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| Series: | Journal of Craniovertebral Junction and Spine |
| Subjects: | |
| Online Access: | http://www.jcvjs.com/article.asp?issn=0974-8237;year=2013;volume=4;issue=2;spage=49;epage=55;aulast=Krüger |
| _version_ | 1819169770108354560 |
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| author | Antonio Krüger Ludwig Oberkircher Thomas Frangen Steffen Ruchholtz Christian Kühne Andreas Junge |
| author_facet | Antonio Krüger Ludwig Oberkircher Thomas Frangen Steffen Ruchholtz Christian Kühne Andreas Junge |
| author_sort | Antonio Krüger |
| collection | DOAJ |
| description | Introduction: Occipital condyle fractures (OCFs) are considered to be rare injuries. OCFs are now diagnosed more often because of the widespread use of computed tomography. Our aim is to report the incidence, treatment and long term outcome of 8 patients with OCFs. Materials and Methods: All patients presenting with multiple trauma from 1993 to 2006 were analyzed retrospectively. Characteristics and course of the treatment were evaluated. Follow-up was performed after 11,7 years (range 5,9 to 19,3 years). Results: Nine cases of OCF in 8 patients were identified. All injuries resulted from high velocity trauma. The average scores on the ISS Scale were 39,6 (24-75) and 7,3 (3-15) on the GCS. According to Anderson′s classification, 5 cases of Type III and 4 cases of Type I fractures were identified. According to Tuli′s classification, 5 cases of Type IIA and 4 cases of Type I were found. Indications for immobilization with the halo-vest were type III injuries according to Anderson′s classification or Tuli′s type IIA injuries, respectively. Patients with Tuli′s type I injuries were treated with a Philadelphia collar for 6 weeks. In one patient with initial complete tetraplegia and one with incomplete neurological deficits the final follow-up neurologic examination showed no neurological impairment at all (Frankel-grade A to E, respectively B to E). At follow-up, 3 patients were asymptomatic. Four patients suffered from mild pain when turning their head, pain medication was necessary in one case only. Discussion: OCF`s are virtually undetectable using conventional radiography. In cases of high velocity, cranio-cervical trauma or impaired consciousness, high resolution CT-scans of the craniocervical junction must be performed. We suggest immobilization using a halo device for type III injuries according to Anderson′s classification or Tuli′s type IIa injuries, respectively. Patients with Tuli′s type I injuries should be treated with a Philadelphia collar. |
| first_indexed | 2024-12-22T19:24:46Z |
| format | Article |
| id | doaj.art-f03d5f505f7e4786bd324e7145dd2fac |
| institution | Directory Open Access Journal |
| issn | 0974-8237 |
| language | English |
| last_indexed | 2024-12-22T19:24:46Z |
| publishDate | 2013-01-01 |
| publisher | Wolters Kluwer Medknow Publications |
| record_format | Article |
| series | Journal of Craniovertebral Junction and Spine |
| spelling | doaj.art-f03d5f505f7e4786bd324e7145dd2fac2022-12-21T18:15:17ZengWolters Kluwer Medknow PublicationsJournal of Craniovertebral Junction and Spine0974-82372013-01-0142495510.4103/0974-8237.128525Fractures of the occipital condyle clinical spectrum and course in eight patientsAntonio KrügerLudwig OberkircherThomas FrangenSteffen RuchholtzChristian KühneAndreas JungeIntroduction: Occipital condyle fractures (OCFs) are considered to be rare injuries. OCFs are now diagnosed more often because of the widespread use of computed tomography. Our aim is to report the incidence, treatment and long term outcome of 8 patients with OCFs. Materials and Methods: All patients presenting with multiple trauma from 1993 to 2006 were analyzed retrospectively. Characteristics and course of the treatment were evaluated. Follow-up was performed after 11,7 years (range 5,9 to 19,3 years). Results: Nine cases of OCF in 8 patients were identified. All injuries resulted from high velocity trauma. The average scores on the ISS Scale were 39,6 (24-75) and 7,3 (3-15) on the GCS. According to Anderson′s classification, 5 cases of Type III and 4 cases of Type I fractures were identified. According to Tuli′s classification, 5 cases of Type IIA and 4 cases of Type I were found. Indications for immobilization with the halo-vest were type III injuries according to Anderson′s classification or Tuli′s type IIA injuries, respectively. Patients with Tuli′s type I injuries were treated with a Philadelphia collar for 6 weeks. In one patient with initial complete tetraplegia and one with incomplete neurological deficits the final follow-up neurologic examination showed no neurological impairment at all (Frankel-grade A to E, respectively B to E). At follow-up, 3 patients were asymptomatic. Four patients suffered from mild pain when turning their head, pain medication was necessary in one case only. Discussion: OCF`s are virtually undetectable using conventional radiography. In cases of high velocity, cranio-cervical trauma or impaired consciousness, high resolution CT-scans of the craniocervical junction must be performed. We suggest immobilization using a halo device for type III injuries according to Anderson′s classification or Tuli′s type IIa injuries, respectively. Patients with Tuli′s type I injuries should be treated with a Philadelphia collar.http://www.jcvjs.com/article.asp?issn=0974-8237;year=2013;volume=4;issue=2;spage=49;epage=55;aulast=KrügerLong-term outcomemultiple traumaoccipital condyle fracture |
| spellingShingle | Antonio Krüger Ludwig Oberkircher Thomas Frangen Steffen Ruchholtz Christian Kühne Andreas Junge Fractures of the occipital condyle clinical spectrum and course in eight patients Journal of Craniovertebral Junction and Spine Long-term outcome multiple trauma occipital condyle fracture |
| title | Fractures of the occipital condyle clinical spectrum and course in eight patients |
| title_full | Fractures of the occipital condyle clinical spectrum and course in eight patients |
| title_fullStr | Fractures of the occipital condyle clinical spectrum and course in eight patients |
| title_full_unstemmed | Fractures of the occipital condyle clinical spectrum and course in eight patients |
| title_short | Fractures of the occipital condyle clinical spectrum and course in eight patients |
| title_sort | fractures of the occipital condyle clinical spectrum and course in eight patients |
| topic | Long-term outcome multiple trauma occipital condyle fracture |
| url | http://www.jcvjs.com/article.asp?issn=0974-8237;year=2013;volume=4;issue=2;spage=49;epage=55;aulast=Krüger |
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