title: Occipital condyle fractures. Prospective follow-up of 31 cases within 5 years at a level 1 trauma centre.
abstract: OBJECTIVE
  Prospective investigation of incidence and outcome of occipital condyle fractures (OCF) in a level 1 trauma centre.
  
  
  METHODS
  Over a period of 5 years, we prospectively recorded all cases of OCF, and performed a 1-year post-injury radiological and clinical follow-up using CT imaging, SF-36 and Neck Disability Index, respectively.
  
  
  RESULTS
  A total of 31 patients with OCF were identified. Based on a total of 2,616 CT scans that had been performed during this period, the incidence was 1.19%. There were 27 unilateral and 4 bilateral OCFs. Furthermore, 3 out of 31 patients (9.7%) were additionally diagnosed with atlanto-occipital dislocation (AOD), one of which was dorsally stabilised in a surgical procedure. All other patients were treated conservatively. 5 out of 31 patients (16.1%) died due to the severity of associated injuries. 22 out of 31 patients (70.9%) were prospectively followed-up for 1 year after trauma. During this period, CT imaging showed bony consolidation of fractures in all cases except for one, with no evidence of secondary dislocation or nonunion. Evaluation of the Neck Disability Index showed moderate disability. The SF-36 questionnaire showed an impaired quality of life in all areas; however, these were determined by associated injuries and independent of the type of fracture.
  
  
  CONCLUSIONS
  Both unilateral and bilateral OCFs represent a stable injury regardless of the type of fracture. If AOD has been diagnosed in addition, it requires surgical stabilisation-independent of the OCF-and it is a significant predictor for poor outcomes. The patients quality of life 1 year after trauma has not been affected by the OCF, but by the overall pattern of the injury and by comorbidities. Based on our results, we introduce a new, simple and practical classification for OCFs.
authors.affiliation: Department of Trauma Surgery, University Hospital Regensburg, 93042 Regensburg, Germany. muellerfj5@aol.com
authors.forename: Franz Josef
authors.initials: FJ
authors.lastname: Mueller
authors.forename: Bernd
authors.initials: B
authors.lastname: Fuechtmeier
authors.forename: Bernd
authors.initials: B
authors.lastname: Kinner
authors.forename: Michael
authors.initials: M
authors.lastname: Rosskopf
authors.forename: Carsten
authors.initials: C
authors.lastname: Neumann
authors.forename: Michael
authors.initials: M
authors.lastname: Nerlich
authors.forename: Carsten
authors.initials: C
authors.lastname: Englert
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005500:Follow-Up Studies; D005858:Germany / Q000453:epidemiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D009777:Occipital Bone / Q000293:injuries*; D011446:Prospective Studies; D011859:Radiography; D012887:Skull Fractures / Q000000981:diagnostic imaging* / Q000401:mortality; D014193:Trauma Centers; D016896:Treatment Outcome; D055815:Young Adult