THE FORGOTTEN CONDYLE - THE APPEARANCE, MORPHOLOGY, AND CLASSIFICATION OF OCCIPITAL CONDYLE FRACTURES

PURPOSE: To evaluate the appearance, morphology, and treatment of occi pital condyle fractures (OCF). METHODS: Cases were collected by a retr ospective and prospective analysis of teaching files and case logs. pa tients' charts, when available, were reviewed for age, sex, mode of in jury, physical examination, Glascow Coma Scale score, and associated i njuries. Plain films and CT images were reviewed to determine OCF type and to assess for the presence of associated cervical spine and/or in tracranial trauma. RESULTS: Fifteen patients with OCF, 13 occurring in a 43-month period, were identified. Ten patients were involved in mot or vehicle accidents. Severity of closed head injury and associated cl inical findings were variable. Three patients had associated cervical spine fracture. According to the Anderson and Montesano classification , two patients (13%) had type I OCF, eight patients (54%) had type II OCF, and five (33%) had type III OCF. Fourteen of the fractures were i dentified on screening trauma head. CT scans. Treatment varied accordi ng to the presence of associated injuries and stability of the cervica l spine. CONCLUSIONS: Although OCFs are rare, they will be encountered by most radiologists who see a significant amount of trauma. Type II OCFs were the most common fracture type in our series. Type III fractu res were the second most common and potentially unstable. CT should be initiated at the level of the C-l ring to screen for the presence of OCF in all patients who have suffered trauma.