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CC BY 4.0 · Indian Journal of Neurosurgery 2024; 13(01): 068-072
DOI: 10.1055/s-0043-1771496
Case Report

What Factors Influence the Final Outcome in Occipital Condyle Fractures?

U. S. Srinivasan
1   Department of Neurosurgery, Sri Balaji Hospitals, Chennai, Tamil Nadu, India
,
Al-Busaidi Ali Sultan
2   Department of Radiology, Nizwa Hospital, Nizwa, Oman
,
Eltayeb Abdalla Ali Mubarak
3   Department of Surgery, Nizwa Hospital, Nizwa, Oman
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Abstract

Introduction Diagnosis of occipital condyle fracture (OCF) following a trauma needs high awareness among the trauma surgeons.

Aim In our study, we attempt to discern if any factor or a combination of factors influences the final outcome following OCF.

Materials and Methods We prospectively analyzed the outcome in OCF patients admitted during 2017 to 2019 at our center. We had 14 patients with polytrauma with OCF. Among them two were lost for follow-up. So, 12 patients were followed up for 6 months after injury. The following 10 factors were analyzed—age, sex, injury, Glasgow Coma Scale, Injury Severity Score, spinal injury, associated injuries, blood pressure, medical conditions, and surgical intervention. Outcome was divided into good and poor outcomes. Chi-squared test was used. All these patients were treated conservatively for OCF for 3 months.

Results There was no significant factor, since p-value was greater than 0.05 for all variables. Only Injury Severity Score (0.091) was close to the significant p-value. Seven patients had severe head injuries and among them one died and four had the worst outcome. Among the five patients who had spinal injuries, only two had good outcomes.

Conclusion Our results indicate that the outcome following OCF is not determined by any single factor. Injury Severity Score comes close to determining the final outcome. This indicates that the overall patient management especially of associated injuries is the determining factor in the outcome in patients who had sustained OCF.

Keywords

occipital condyle fracture - Polytrauma - head injuries


Publication History

Article published online:
10 August 2023

© 2023. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)

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  • References

  • 1 Maserati MB, Stephens B, Zohny Z. et al. Occipital condyle fractures: clinical decision rule and surgical management. J Neurosurg Spine 2009; 11 (04) 388-395
    CrossrefPubMedGoogle Scholar
  • 2 Malham GM, Ackland HM, Jones R, Williamson OD, Varma DK. Occipital condyle fractures: incidence and clinical follow-up at a level 1 trauma centre. Emerg Radiol 2009; 16 (04) 291-297
    CrossrefPubMedGoogle Scholar
  • 3 Hanson JA, Deliganis AV, Baxter AB. et al. Radiologic and clinical spectrum of occipital condyle fractures: retrospective review of 107 consecutive fractures in 95 patients. AJR Am J Roentgenol 2002; 178 (05) 1261-1268
    CrossrefPubMedGoogle Scholar
  • 4 Aulino JM, Tutt LK, Kaye JJ, Smith PW, Morris Jr JA. Occipital condyle fractures: clinical presentation and imaging findings in 76 patients. Emerg Radiol 2005; 11 (06) 342-347
    CrossrefPubMedGoogle Scholar
  • 5 Anderson PA, Montesano PX. Morphology and treatment of occipital condyle fractures. Spine 1988; 13 (07) 731-736
    CrossrefPubMedGoogle Scholar
  • 6 Byström O, Jensen TS, Poulsen FR. Outcome of conservatively treated occipital condylar fractures - a retrospective study. J Craniovertebr Junction Spine 2017; 8 (04) 322-327
    CrossrefPubMedGoogle Scholar
  • 7 Shi J, Shen J, Zhu M. et al. A new weighted injury severity scoring system: better predictive power for adult trauma mortality. Inj Epidemiol 2019; 6 (40) 40
    CrossrefPubMedGoogle Scholar
  • 8 Tuli S, Tator CH, Fehlings MG, Mackay M. Occipital condyle fractures. Neurosurgery 1997; 41 (02) 368-376 , discussion 376–377
    CrossrefPubMedGoogle Scholar
  • 9 Mueller FJ, Fuechtmeier B, Kinner B. et al. Occipital condyle fractures. Prospective follow-up of 31 cases within 5 years at a level 1 trauma centre. Eur Spine J 2012; 21 (02) 289-294
    CrossrefPubMedGoogle Scholar
  • 10 Alves OL, Pereira L, Kim SH. et al. Upper cervical spine trauma: WFNS spine committee recommendations. Neurospine 2020; 17 (04) 723-736
    CrossrefPubMedGoogle Scholar
  • 11 Menendez DF, Palva WS, Sousa Junior LdM, Neville IS, Andrade AF, Teixeira MJ. . Non-operative management of occipital condyle fracture: report of three cases and literature review. Rev Chil Neurocirugia 2015; 41: 93-96
    PubMedGoogle Scholar
  • 12 Pang D, Nemzek WR, Zovickian J. Atlanto-occipital dislocation: part 1–normal occipital condyle-C1 interval in 89 children. Neurosurgery 2007; 61 (03) 514-521 , discussion 521
    CrossrefPubMedGoogle Scholar
  • 13 Pang D, Nemzek WR, Zovickian J. Atlanto-occipital dislocation–part 2: the clinical use of (occipital) condyle-C1 interval, comparison with other diagnostic methods, and the manifestation, management, and outcome of atlanto-occipital dislocation in children. Neurosurgery 2007; 61 (05) 995-1015 , discussion 1015
    CrossrefPubMedGoogle Scholar