Occipital_Condyle_Fractures

Question 1

Classification systems for occipital condyle fractures

Answer 1

Anderson and Montesano

Harborview

Question 2

Occipital condole fractures
SCI %
Mortality%

Answer 2

Occipital condole fractures
SCI % - 31%
Mortality% - 11%

Question 3

Anderson and Montesano classification of occipital condyle fractures

Answer 3

Type 1 (3%) - impaction type with comminution of occipital condyle; due to compression if joint; stable
Type 2 (22%) - basilar skull fracture extending into one or both condyle; direct blow; stable as alar ligament and tectorial membrane usually preserved
Type 3 (75%) - avulsion of condyle in region of alarm ligament attachment; rotational/lateral bending; suspect underlying occipitocervical dissociation

Question 4

Harborview Classification of Craniocervical Injuries

Answer 4

MRI shows craniocervical ligament injury

Type I - craniocervical alignment is within 2mm of normal; <2mm distraction with traction

Type II - craniocervical alignment is within 2mm of normal; >2mm distraction with traction

Type III - craniocervical alignment >2mm of normal; >2mm distraction with traction

Question 5

Treatment of Occipital condyle fractures

Answer 5

Anderson and Montesano

Type 1 and 2 - analgesics and cervical orthosis (Type 3 if not overtly unstable)

Type 3 - occiput to C3 fusion (decompression if needed).

Question 6

Preferred trajectory for C1-2 lateral mass screws?

Answer 6

10 deg medial

22 deg cephalad

Question 7

Progression of subaxial facet joint orientation

Answer 7

C3 superior articular facet posteromedial to posterlateral at C7-T1

C5-6 is most common transition

Question 8

Side of dominant vertebral artery

Answer 8

Left