FRACTURE OF THE OCCIPITAL CONDYLES AND ASSOCIATED CRANIOCERVICAL LIGAMENT INJURY - INCIDENCE, CT IMAGING AND IMPLICATIONS

Thin section contiguous axial computer tomography (CT) was used to dem onstrate fractures of the occipital condyle and craniocervical ligamen t injury. During a 12-month period, 55 consecutive patients who had su stained high energy blunt trauma to the head or upper cervical region were examined (38 male and 17 female, age range 3-80 years, median 24 years). If occipital condyle fracture was suspected clinically, CT was performed from C2 to the foramen magnum with two dimensional sagittal , coronal, and curvilinear reconstructions and employing bone and soft tissue windows, Occipital condyle fractures were classified according to Anderson and Montesano types 1, 2 or 3. Injury to the internal cra niocervical ligaments was described, Nine of 55 patients had occipital condyle fractures (16.4%). Injury of the alar ligaments was demonstra ted in four and tectorial membrane injury in two patients, Three of th e nine patients had associated fractures of cervical vertebrae. Five o f nine patients had a normal Glasgow coma scale on admission (55 %) an d in two patients the occupital condyle fracture was the only signific ant injury. Plain cervical radiographs were non-diagnostic, Two patien ts had significant pain and limited motion of the craniocervicum sever al months following injury, In conclusion, CT should be performed wher e there is a high clinical suspicion of occipital condyle fracture, th at is based mainly on the mechanism of injury.