van der Burg Stijn J, Pouw Martin H, Brink Monique, Dekker Helena, Kunst Henricus P M, Hosman Allard J F
Department of Orthopaedic Surgery, Radboud University Nijmegen Medical Centre, Nijmegen, Netherlands.
Department of Medical Imaging, Radboud University Nijmegen Medical Centre, Nijmegen, Netherlands.
J Craniovertebr Junction Spine. 2020 Jul-Sep;11(3):173-179. doi: 10.4103/jcvjs.JCVJS_100_20. Epub 2020 Aug 14.
No consensus about classification, treatment, and clinical relevance of occipital condyle fractures (OCFs) exists.
The aim of the study was to determine radiological, clinical, and functional outcome of OCFs and thereby determine its clinical relevance.
This was a retrospective analysis of a prospective follow-up study.
From May 2005 to May 2008, all OCFs were included from a Level-1 trauma center. Patient files were reviewed for patient and fracture characteristics. Fracture classification was done according to the Anderson criteria. Clinical outcome was assessed by completing two questionnaires, radiological outcome by computed tomography imaging, and functional outcome by measuring active cervical range of motion using a Cybex EDI-320.
A Fisher's exact Test was used in categorical variables and a one-sample -test for comparing means of active cervical range of motion in occipital fracture patients with normal values. An independent samples -test was carried out to compare the means of groups with and without accompanying cervical fractures for each motion.
Thirty-nine patients were included (4 type I, 16 type II, and 19 type III). Twenty-seven patients completed follow-up, of whom 26 were treated conservatively. Fracture healing was established in 25 of 28 fractures at a median follow-up of 19 months. Eleven patients had none to minimal pain or disability at follow-up, 12 had mild, and two had moderate pain or disability on questionnaires. No statistically significant difference in active cervical range of motion was identified comparing means stratified for accompanying cervical fractures.
Conservatively treated patients with an OCF generally show favorable radiological and clinical outcome.
关于枕髁骨折（OCF）的分类、治疗及临床相关性尚无共识。
本研究旨在确定枕髁骨折的放射学、临床及功能转归，从而确定其临床相关性。
这是一项对前瞻性随访研究的回顾性分析。
2005年5月至2008年5月期间，纳入一级创伤中心的所有枕髁骨折患者。查阅患者病历以了解患者及骨折特征。骨折分类依据安德森标准进行。通过完成两份问卷评估临床转归，通过计算机断层扫描成像评估放射学转归，通过使用Cybex EDI - 320测量颈椎活动度评估功能转归。
分类变量采用费舍尔精确检验，将枕骨骨折患者的颈椎活动度均值与正常值进行比较采用单样本t检验。对每组有或无合并颈椎骨折的患者进行独立样本t检验，比较各活动度的均值。
共纳入39例患者（I型4例，II型16例，III型19例）。27例患者完成随访，其中26例接受保守治疗。28例骨折中25例在中位随访19个月时骨折愈合。随访时11例患者无疼痛或仅有轻微残疾，12例有轻度疼痛或残疾，2例在问卷中显示有中度疼痛或残疾。比较伴有颈椎骨折分层后的均值，未发现颈椎活动度有统计学显著差异。
枕髁骨折保守治疗的患者通常显示出良好的放射学及临床转归。
