Occipital condyle fracture

A.Prof Frank Gaillard and Dr Andrew Dixon et al.

Occipital condylar fractures result from high-energy blunt trauma and is a specific and localized type of basilar skull fracture.

The exact incidence of these fractures is unknown but are reported to occur in 3-4% patients with moderate-severe traumatic brain injuries 3.

History and examination are unreliable, and high suspicion should be maintained in patients with an appropriate mechanism 3.

Blunt high-energy trauma to the head/neck, in particular 3:

  • axial compression
  • lateral bending
  • axial rotation
  • direct blow

The fractures can be subdivided into three types based on the morphology and mechanism of injury 1,2:

  • type I fracture (~15%)
    • impaction fracture of the occipital condyle
    • due to axial compression
    • stable injury
  • type II fracture (~50%)
    • basilar skull fracture that extends to involve the occipital condyle
    • due to a direct blow to the skull
    • stable injury
  • type III fracture (~35%)
    • avulsion injury of the condyle in the region of alar ligament attachment
    • due to forced contralateral bending and rotation
    • potentially unstable injury

Type I and II injuries are generally stable because the alar ligament and tectorial membrane are preserved, while type 3 is potentially unstable.

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Article information

rID: 10021
Synonyms or Alternate Spellings:
  • Occipital condyle fractures

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Cases and figures

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    Case 1: type 3
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    Case 2
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