Occipital condyle fractures: a hidden nosologic entity. An experience with 10 cases.
BACKGROUND
To report the incidence, treatment and outcome of occipital condyle fractures (OCFs) based on the experience of a single neurosurgical department over a period of two years.


METHODS
From April 1999 to April 2001, ten cases of OCFs were identified in 110 cervical traumas observed over a period of two years. Patients were studied by cervical x-rays, high-resolution CT scan with a 1-2 mm slice of the cranio-cervical junction (CCJ) and MRI in selected cases to evaluate the integrity of supporting ligaments. According to the Anderson and Montesano classification, 5 cases of type III, 3 cases of type II and 2 cases of type I fractures were found. Dysfunction of lower cranial nerves was observed in 8 cases. Treatment was conservative in all cases.


RESULTS
At follow-up, ranging from 18 months to 2 years, fusion was obtained in all cases; 8 patients were neurologically intact, one patient presented a mild persistent dysphonia and another mild trapezius weakness.


CONCLUSIONS
OCFs are actually not rare, rather they are often overlooked. In cases of high-energy trauma of the cervical spine, the diagnostic suspicion should be kept in mind.High-resolution CT scan with slice at 1-2 mm of the CCJ is the key radiological examination in the diagnosis of this lesion. Conservative treatment using a hard collar is sufficient to obtain sound fusion.
Capuano
C
C
Department of Neurosurgery, University of Florence, Florence, Italy. ccapuano75@email.it
Costagliola
C
C
Shamsaldin
M
M
Maleci
A
A
Di Lorenzo
N
N
D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D015600:Glasgow Coma Scale; D006801:Humans; D008297:Male; D008875:Middle Aged; D018908:Muscle Weakness / Q000209:etiology; D009777:Occipital Bone / Q000000981:diagnostic imaging / Q000293:injuries* / Q000473:pathology; D011859:Radiography; D012887:Skull Fractures / Q000175:diagnosis* / Q000628:therapy*; D016896:Treatment Outcome; D014832:Voice Disorders / Q000209:etiology