Occipital condyle fracture classifications help assess stability in pediatric patients, Study says
Figure: T2-weighted Magnetic Resonance Imaging of the brain, showing abnormal signal changes in the periventricular white matter, severe in occipital lobe regions, with mass effect on pons and medulla.
Occipital condyle fractures (OCFs) in patients before 18 years of age are rare. Classifications of OCF are based on the CT images of the cranio-cervical junction (CCJ) and MRI. The Anderson-Montesano and Tuli classifications of OCF can be used to assess the stability of OCF in adolescents, but both classifications should be used simultaneously, finds a study.
The research is published in the Journal of Orthopaedic Surgery and Research.
The Anderson-Montesano and Tuli classifications are the types which are most commonly used in occipital condyle fracture (OCFs) cases. Ryszard Tomaszewski et al from the Department of Pediatric Traumatology and Orthopedy, Upper Silesian Child Centre in Katowice, Poland carried out the study with the aim to evaluate the effectiveness of using the OCF classification in pediatric patients.
The authors treated a total of 6 pediatric patients with OCFs, aged 14–18. Two patients with unstable fracture III according to Anderson-Montesano and IIB according to Tuli were treated with the halo-vest.
Additionally, one patient presenting neurological symptoms and with an associated C1 fracture was qualified for the halo-vest stabilization as well. The other patients were treated with a Minerva collar. The researchers evaluated the results 6 months after completing the OCF treatment using the Neck Disability Index (NDI) and SF-36 questionnaires.
Confidence intervals for the mean values were verified using the MeanCI function (from the R library DescTools) for both classical and bootstrap methods.
The authors reported that based on NDI results, the patients obtained an average of 4.33/45 points (2–11) and 9.62% (4.4–24.4). Based on the SF-36 questionnaire, an average of 88.62% (47.41–99.44) was obtained.
Therefore, the authors concluded the following-
a. The Anderson-Montesano and Tuli's classifications of OCF can be used to assess the stability of OCFs in adolescents, but both classifications should be used simultaneously.
b. CT and MR imaging should be used in diagnosing OCFs, whereas CT allows assessing therapeutic outcomes in OCFs.
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