Management of Type III Occipital Condyle Fractures

dc.contributor.authorKwon, Jae Hyun
dc.contributor.authorChinthala, Anoop Sai
dc.contributor.authorArnold, Jonathan C.
dc.contributor.authorWitten, Andrew J.
dc.contributor.authorBohnstedt, Bradley N.
dc.contributor.departmentNeurological Surgery, School of Medicine
dc.date.accessioned2025-02-17T17:47:12Z
dc.date.available2025-02-17T17:47:12Z
dc.date.issued2024-12-15
dc.description.abstractBackground/Objectives: Occipital condyle fractures (OCFs) can be seen in around 4-19% of patients who suffer from cervical spine trauma. Anderson and Montesano system type III OCFs, which are avulsion fractures, are potentially unstable and operative. This study evaluates the management of type III OCFs at our institution over a 22-year period. Methods: This retrospective study reviewed all cases of type III OCFs at our institution from July 2001 to March 2023, identified via imaging reports. Using the in-house radiology imaging informatics system "Doris" (Dig Our Radiology Information System), reports containing the terms subluxation, avulsion, unstable, or type 3/III with occipital condyle, occipital condylar, occipital fx, or occipital fracture were collected. We also searched for Montesano type III/3 fracture. Electronic medical records were used to collect clinical and demographic data. Patients evaluated by the neurosurgical team with at least 1 month of follow-up were included in the analysis. Results: A total of 563 patients were identified with type III OCFs. A total of 56 patients met the inclusion criteria. The majority (91%, 51/56) were treated conservatively with cervical orthosis. A small subset (8.9%, 5/56) underwent occipito-cervical fusion. Three had concomitant unstable C1 fractures, while the other two had significant coronal deformity associated with their type III OCF. Conclusions: At our institution, type III OCFs are predominantly managed with cervical orthosis. Only those with an associated malalignment of the occipito-cervical joint underwent fusion. These findings suggest that most type III OCFs can be treated conservatively with orthosis once stability is confirmed with an upright radiograph.
dc.eprint.versionFinal published version
dc.identifier.citationKwon JH, Chinthala AS, Arnold JC, Witten AJ, Bohnstedt BN. Management of Type III Occipital Condyle Fractures. J Clin Med. 2024;13(24):7639. Published 2024 Dec 15. doi:10.3390/jcm13247639
dc.identifier.urihttps://hdl.handle.net/1805/45752
dc.language.isoen_US
dc.publisherMDPI
dc.relation.isversionof10.3390/jcm13247639
dc.relation.journalJournal of Clinical Medicine
dc.rightsAttribution 4.0 Internationalen
dc.rights.urihttps://creativecommons.org/licenses/by/4.0
dc.sourcePMC
dc.subjectOccipital condyle fracture
dc.subjectCervical spine trauma
dc.subjectOccipito-cervical fusion
dc.subjectOrthosis
dc.titleManagement of Type III Occipital Condyle Fractures
dc.typeArticle
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