title: Occipital condyle fractures: incidence and clinical follow-up at a level 1 trauma centre.
abstract: The purpose of the study was to investigate the incidence, management, and outcomes of occipital condyle fractures at a level 1 trauma center. Blunt trauma patients with occipital condyle fracture admitted to a level 1 trauma center over a 3-year period were identified. Prospective clinical and functional follow-up was undertaken, including further radiographic imaging. The incidence of occipital condyle fracture in patients presenting to our level 1 trauma center was 1.7/1,000 per year. Twenty-four patients were followed up at a mean of 27 months post-injury. There was one case of isolated occipital condyle fracture; all other patients had sustained additional orthopedic, cervical spine, and/or head injury. Seven (29%) patients sustained unilateral Type III avulsion fractures, none of which were isolated injuries. Traumatic brain injury was detected in 46% of study patients, and 42% had cervical spine injury. External halothoracic immobilization was used in 33% of cases. Fracture union with anatomical alignment occurred in 21 patients (88%). No patient had cranial nerve deficit at admission or follow-up. Three patients (12.5%) had moderate to severe neck pain/disability at follow-up, all of whom had sustained multiple injuries. Occipital condyle fractures most frequently occur in conjunction with additional injuries, particularly head and cervical spine injuries. Most cases can be managed successfully nonoperatively. Functional outcome is generally determined by pain and disability related to other injuries, rather than occipital fracture configuration.
authors.affiliation: Department of Neurosurgery, The Alfred Hospital, Commercial Road, Melbourne, 3004, Australia. g.malham@alfred.org.au
authors.forename: Gregory M
authors.initials: GM
authors.lastname: Malham
authors.forename: Helen M
authors.initials: HM
authors.lastname: Ackland
authors.forename: Rachel
authors.initials: R
authors.lastname: Jones
authors.forename: Owen D
authors.initials: OD
authors.lastname: Williamson
authors.forename: Dinesh K
authors.initials: DK
authors.lastname: Varma
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001315:Australia / Q000453:epidemiology; D004185:Disability Evaluation; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009777:Occipital Bone / Q000293:injuries*; D012042:Registries; D012189:Retrospective Studies; D012887:Skull Fractures / Q000175:diagnosis* / Q000453:epidemiology* / Q000209:etiology / Q000628:therapy; D036542:Tomography, Spiral Computed; D014193:Trauma Centers; D015599:Trauma Severity Indices; D014949:Wounds, Nonpenetrating / Q000150:complications*