Occipital Condyle Fracture: A Case Report of a Typically Stable Fracture That Required Surgical Treatment

An occipital condyle fracture (OCF) is a relatively rare trauma that is now increasingly diagnosed because of the wide availability of computed tomography. For nondisplaced OCFs, conservative treatment is generally recommended, and there is no previous report of a nondisplaced OCF requiring surgery....

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Main Authors: Takeshi Suzuki, Satoshi Maki, Masaaki Aramomi, Tomonori Yamauchi, Manato Horii, Koui Kawamura, Hiroshi Sugiyama, Seiji Ohtori
Format: Article
Language:English
Published: Wiley 2018-01-01
Series:Case Reports in Orthopedics
Online Access:http://dx.doi.org/10.1155/2018/2809546
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author Takeshi Suzuki
Satoshi Maki
Masaaki Aramomi
Tomonori Yamauchi
Manato Horii
Koui Kawamura
Hiroshi Sugiyama
Seiji Ohtori
author_facet Takeshi Suzuki
Satoshi Maki
Masaaki Aramomi
Tomonori Yamauchi
Manato Horii
Koui Kawamura
Hiroshi Sugiyama
Seiji Ohtori
author_sort Takeshi Suzuki
collection DOAJ
description An occipital condyle fracture (OCF) is a relatively rare trauma that is now increasingly diagnosed because of the wide availability of computed tomography. For nondisplaced OCFs, conservative treatment is generally recommended, and there is no previous report of a nondisplaced OCF requiring surgery. We report a patient who had a nondisplaced OCF with craniocervical misalignment (a condyle-C1 interval > 2.0 mm) and C1-C2 translation treated with a halo vest and occipitocervical fusion surgery. An 87-year-old Asian woman fell from a 4-meter height and hit her head. She was transferred to our emergency room. Computed tomography revealed a nondisplaced impaction OCF with a 2.5 mm occipital condyle-C1 interval and a 5 mm C1-C2 translation. The fracture pattern was considered stable. However, since craniocervical misalignment and C1-C2 translation were present, the patient was placed in a halo device, and we reduced the occipitoatlantoaxial joint, adjusting the halo ring position preoperatively. Confirming reduction of the atlantooccipital facet joint and the atlantoaxial joint by computed tomography, we performed an occipitocervical fusion. This is the first report of a nondisplaced OCF with craniocervical misalignment and C1-C2 translation that required surgical treatment. Clinicians should be aware of craniocervical misalignment and atlantoaxial instability even in Tuli type 1 OCFs.
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spelling doaj-art-e8ed134d3951438ebee20d273d1a09682025-02-03T07:25:59ZengWileyCase Reports in Orthopedics2090-67492090-67572018-01-01201810.1155/2018/28095462809546Occipital Condyle Fracture: A Case Report of a Typically Stable Fracture That Required Surgical TreatmentTakeshi Suzuki0Satoshi Maki1Masaaki Aramomi2Tomonori Yamauchi3Manato Horii4Koui Kawamura5Hiroshi Sugiyama6Seiji Ohtori7Department of Orthopaedic Surgery, Asahi General Hospital, i1326 Asahi, Chiba 289-2511, JapanDepartment of Orthopaedic Surgery, Asahi General Hospital, i1326 Asahi, Chiba 289-2511, JapanDepartment of Orthopaedic Surgery, Asahi General Hospital, i1326 Asahi, Chiba 289-2511, JapanDepartment of Orthopaedic Surgery, Asahi General Hospital, i1326 Asahi, Chiba 289-2511, JapanDepartment of Orthopaedic Surgery, Asahi General Hospital, i1326 Asahi, Chiba 289-2511, JapanDepartment of Orthopaedic Surgery, Asahi General Hospital, i1326 Asahi, Chiba 289-2511, JapanDepartment of Orthopaedic Surgery, Asahi General Hospital, i1326 Asahi, Chiba 289-2511, JapanDepartment of Orthopaedic Surgery, Chiba University, Graduate School of Medicine, 1-8-1 Inohana Chuou-ku, Chiba, Chiba 260-8670, JapanAn occipital condyle fracture (OCF) is a relatively rare trauma that is now increasingly diagnosed because of the wide availability of computed tomography. For nondisplaced OCFs, conservative treatment is generally recommended, and there is no previous report of a nondisplaced OCF requiring surgery. We report a patient who had a nondisplaced OCF with craniocervical misalignment (a condyle-C1 interval > 2.0 mm) and C1-C2 translation treated with a halo vest and occipitocervical fusion surgery. An 87-year-old Asian woman fell from a 4-meter height and hit her head. She was transferred to our emergency room. Computed tomography revealed a nondisplaced impaction OCF with a 2.5 mm occipital condyle-C1 interval and a 5 mm C1-C2 translation. The fracture pattern was considered stable. However, since craniocervical misalignment and C1-C2 translation were present, the patient was placed in a halo device, and we reduced the occipitoatlantoaxial joint, adjusting the halo ring position preoperatively. Confirming reduction of the atlantooccipital facet joint and the atlantoaxial joint by computed tomography, we performed an occipitocervical fusion. This is the first report of a nondisplaced OCF with craniocervical misalignment and C1-C2 translation that required surgical treatment. Clinicians should be aware of craniocervical misalignment and atlantoaxial instability even in Tuli type 1 OCFs.http://dx.doi.org/10.1155/2018/2809546
spellingShingle Takeshi Suzuki
Satoshi Maki
Masaaki Aramomi
Tomonori Yamauchi
Manato Horii
Koui Kawamura
Hiroshi Sugiyama
Seiji Ohtori
Occipital Condyle Fracture: A Case Report of a Typically Stable Fracture That Required Surgical Treatment
Case Reports in Orthopedics
title Occipital Condyle Fracture: A Case Report of a Typically Stable Fracture That Required Surgical Treatment
title_full Occipital Condyle Fracture: A Case Report of a Typically Stable Fracture That Required Surgical Treatment
title_fullStr Occipital Condyle Fracture: A Case Report of a Typically Stable Fracture That Required Surgical Treatment
title_full_unstemmed Occipital Condyle Fracture: A Case Report of a Typically Stable Fracture That Required Surgical Treatment
title_short Occipital Condyle Fracture: A Case Report of a Typically Stable Fracture That Required Surgical Treatment
title_sort occipital condyle fracture a case report of a typically stable fracture that required surgical treatment
url http://dx.doi.org/10.1155/2018/2809546
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