Traumatic occipital condyle fractures (OCF) are infrequent injuries associated with severely injured trauma patients. The aim of our study was to examine the relevance of OCF in polytraumatic patients and discuss the role of concomitant injuries in these patients.
Clinical and radiological data at admission and follow-up was documented by medical chart review after patient selection through query of our radiological database. Descriptive statistics were used to present epidemiological data of 152 patients.
Female to male ratio was roughly 1:2 and mean age at presentation was 58 years. Mean hospitalization time was 9.8 days. Trauma mechanism was a fall <2 meters in 29% of cases, a fall >2 meters in 25%, a motor vehicle accident (MVA) as a passenger in 9%, a MVA as a pedestrian in 5%, a bicycle accident (<40 km/h) in 18% and a scooter, ski or motorbike accident (>40km/h) in 14% of cases.
14% of OCF were classified as Anderson and Montesano type 1, 37% as type 2 and 49% as type 3.
60% of patients were diagnosed with concomitant intracranial injuries, 14% of patients had associated fractures of the upper cervical spine and 34% had concomitant fractures of the remaining spine. Spinal cord injury or compression was observed in 8% of patients, however never at the level of the OCF. 28% of patients had concomitant injuries of the thorax, abdomen, extremities and/or pelvis
9.2% of patients showed focal neurological deficits and 65% presented with a reduced mental state.
Epidemiology of OCF in our study was comparable to smaller published cohorts. OCF may be seen as markers for severe trauma; however, their stand-alone role and influence on initial neurological impairment is not clear in view of more severe concomitant injuries and must be further investigated.