Occipital condyle fractures revisited.

IF 1.7 Q3 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

Emergency Radiology Pub Date : 2024-12-05 DOI:10.1007/s10140-024-02303-4

Mahla Radmard, Armin Tafazolimoghadam, Akua Afrah Amoah, Dhairya A Lakhani, Tej D Azad, Ali Bydon, David M Yousem

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引用次数: 0

Abstract

Purpose: Occipital condyle fractures (OCFs) are classified by the Anderson and Montesano system into Type I (comminuted, minimally displaced), Type II (stable, associated with basilar skull fractures), and Type III (unstable avulsion fractures). We retrospectively analyzed 24,986 cervical spine CT examinations of emergency department patients over five years to determine the incidence and characteristics of OCFs, mechanism of injury, and associated intracranial and cervical spine injuries.

Methods and materials: The study was IRB-approved and HIPAA compliant. We retrospectively reviewed the CT brain and CT cervical spine reports performed from July 2018 to August 2023. Variables collected included age, sex, clinical presentation, coincident brain and cervical spine injuries, treatments, and OCF classifications.

Results: Sixty-three of 24,986 patients (0.25%) had OCFs, predominantly male (41 males, 22 females), with an average age of 51.1 years; 22/63 (34.9%) occurred in asymptomatic patients. Concurrent injuries included cervical spine fractures (33.3%) at C1 and C2 and intracranial injuries (47.6%), mostly subarachnoid and subdural hemorrhages. OCFs were categorized into Anderson-Montesano Type I (9 cases), Type II (24 cases), and Type III (30 cases), with unstable Type III fractures more common in MVC victims; stable fractures had higher rates of intracranial injuries. There were no significant differences in morbidity, mortality, or concurrent cervical spine or chest/abdominal/pelvic findings between stable and unstable OCFs.

Conclusion: The study highlights the importance of comprehensive imaging and evaluation in trauma cases to identify OCFs, even in asymptomatic patients, with a high rate of concurrent C1-2 and intracranial injuries.

Clinical relevance/application: Being aware of occipital condyle fractures, types, and complications is important in the emergency radiology evaluation of trauma patients, especially given high rates of C1-2 fractures and intracranial bleeds.

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枕骨髁骨折复诊。

目的：枕髁骨折（OCFs）被Anderson和Montesano系统分为I型（粉碎性，轻度移位），II型（稳定性，伴有颅底颅骨骨折）和III型（不稳定撕脱性骨折）。我们回顾性分析5年来急诊患者24,986例颈椎CT检查，以确定OCFs的发生率和特征、损伤机制以及相关的颅内和颈椎损伤。方法和材料：本研究经irb批准，符合HIPAA标准。我们回顾性回顾了2018年7月至2023年8月期间的CT脑和CT颈椎报告。收集的变量包括年龄、性别、临床表现、脑和颈椎同时损伤、治疗方法和OCF分类。结果：24,986例患者中有63例（0.25%）发生OCFs，以男性为主（男性41例，女性22例），平均年龄51.1岁；22/63（34.9%）发生在无症状患者中。并发损伤包括颈椎C1和C2骨折（33.3%）和颅内损伤（47.6%），主要是蛛网膜下腔和硬膜下出血。ocf分为Anderson-Montesano I型（9例）、II型（24例）和III型（30例），其中不稳定型III型骨折在MVC患者中更为常见；稳定性骨折的颅内损伤发生率较高。稳定性和不稳定性ocf在发病率、死亡率、并发颈椎或胸/腹/盆腔表现方面没有显著差异。结论：该研究强调了在创伤病例中进行综合成像和评估以识别OCFs的重要性，即使在无症状的患者中也是如此，并发C1-2和颅内损伤的比例很高。临床意义/应用：了解枕骨髁骨折、类型和并发症在创伤患者的急诊放射学评估中是重要的，特别是考虑到C1-2骨折和颅内出血的高发。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Emergency Radiology RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING-

CiteScore

4.60

自引率

4.50%

发文量

期刊介绍： To advance and improve the radiologic aspects of emergency careTo establish Emergency Radiology as an area of special interest in the field of diagnostic imagingTo improve methods of education in Emergency RadiologyTo provide, through formal meetings, a mechanism for presentation of scientific papers on various aspects of Emergency Radiology and continuing educationTo promote research in Emergency Radiology by clinical and basic science investigators, including residents and other traineesTo act as the resource body on Emergency Radiology for those interested in emergency patient care Members of the American Society of Emergency Radiology (ASER) receive the Emergency Radiology journal as a benefit of membership!