Anderson and Montesano classification of occipital condyle fractures
Last revised by Francis Deng on 18 Jan 2022
Citation, DOI, disclosures and article data
Citation:
Hacking C, Deng F, Anderson and Montesano classification of occipital condyle fractures. Reference article, Radiopaedia.org (Accessed on 24 Apr 2024) https://doi.org/10.53347/rID-87202
rID:
87202
Article created:
Disclosures:
At the time the article was created Craig Hacking had no recorded disclosures.
View Craig Hacking's current disclosures
Last revised:
18 Jan 2022,
Francis Deng ◉
Disclosures:
At the time the article was last revised Francis Deng had no recorded disclosures.
View Francis Deng's current disclosures
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Synonyms:
- Anderson-Montesano classification of occipital condyle fractures
The Anderson and Montesano classification is a widely used system for describing occipital condyle fractures. It divides injuries into three types based on morphology and mechanism of injury 1-5.
On this page:
Classification
-
type I: impacted type occipital condyle fracture
- morphology: comminution of the condyle with minimal or no displacement of fragments into the foramen magnum
- mechanism: axial loading of the skull onto the atlas
- stability: stable because the tectorial membrane and contralateral alar ligament are intact (the ipsilateral alar ligament may be functionally inadequate)
-
type II: basilar skull type occipital condyle fracture
- morphology: condyle fracture that extends outside of the condyle to elsewhere in the posterior base of skull
- mechanism: direct blow to the lower skull
- stability: stable because the tectorial membrane and alar ligaments are intact
-
type III: avulsion type occipital condyle fracture
- morphology: small inferomedial occipital condyle fracture fragment displaced toward the odontoid tip
- mechanism: rotation and/or contralateral bending
- stability: potentially unstable due to loading of the contralateral alar ligament and tectorial membrane
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Epidemiology
A range of incidences of the Anderson and Montesano types amongst all occipital condyle fractures has been reported 2,4,6:
- type I: 3-13%
- type II: 22-54%
- type III: 33-75%
History and etymology
The classification was described in 1988 by American orthopedic surgeons Paul A. Anderson and Pasquale X. Montesano on the basis of 6 patients diagnosed by conventional anterior posterior polytomography or CT with coronal reconstructions 1.
See also
References
- 1. Anderson P & Montesano P. Morphology and Treatment of Occipital Condyle Fractures. Spine (Phila Pa 1976). 1988;13(7):731-6. doi:10.1097/00007632-198807000-00004 - Pubmed
- 2. Noble E & Smoker W. The Forgotten Condyle: The Appearance, Morphology, and Classification of Occipital Condyle Fractures. AJNR Am J Neuroradiol. 1996;17(3):507-13. PMC8337992 - Pubmed
- 3. Leone A, Cerase A, Colosimo C, Lauro L, Puca A, Marano P. Occipital Condylar Fractures: A Review. Radiology. 2000;216(3):635-44. doi:10.1148/radiology.216.3.r00se23635 - Pubmed
- 4. Hanson J, Deliganis A, Baxter A et al. Radiologic and Clinical Spectrum of Occipital Condyle Fractures. AJR Am J Roentgenol. 2002;178(5):1261-8. doi:10.2214/ajr.178.5.1781261 - Pubmed
- 5. Riascos R, Bonfante E, Cotes C, Guirguis M, Hakimelahi R, West C. Imaging of Atlanto-Occipital and Atlantoaxial Traumatic Injuries: What the Radiologist Needs to Know. Radiographics. 2015;35(7):2121-34. doi:10.1148/rg.2015150035 - Pubmed
- 6. Aulino J, Tutt L, Kaye J, Smith P, Morris J. Occipital Condyle Fractures: Clinical Presentation and Imaging Findings in 76 Patients. Emerg Radiol. 2005;11(6):342-7. doi:10.1007/s10140-005-0425-0 - Pubmed
Incoming Links
Articles:
Cases:
- Occipital condyle fracture (type 2) with extension into clivus
- Bilateral occipital condyle fracture (type 2)
- Occipital condyle fracture (type 1) and atlas transverse process fracture (type 5)
- Occipital condyle fracture (type 3)
- Bilateral occipital condyle fractures (type 3)
- Occipital condyle fracture (type 1)
- Anderson and Montesano classification of occipital condyle fractures (diagrams)
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