Occipital condyle fracture in a patient with occipitalisation of the atlas.

Occipital condyle fractures and occipitalisation of the atlas are rare entities of the craniocervical junction. To the best of our knowledge, a patient presenting with a traumatic occipital condyle fracture and pre-existing occipitalisation of the atlas has not been previously reported. We report the case of a 79-year-old man presenting with an Anderson and Montesano type III fracture through a fused occipital condyle and lateral mass. This fracture was noted to extend into the transverse foramen and the C1-C2 joint space. The transverse ligament and ligamentum flavum were calcified but not disrupted and the atlantodental interval was within normal limits. The neurological examination was unremarkable with the exception of neck pain. The patient was treated conservatively and placed in a rigid cervical collar for 10 weeks with serial CT studies to monitor healing of the fracture. At 4 months of follow-up, the patient was pain free with nearly complete resolution of his occipital condyle fracture.