Lam Khai S, Carriço Gustavo, Fernandes Felipe M, Nanni Felipe, de La Torre Escobar Carlos
London Bridge Hospital, London, UK.
Hospital SOS CARDIO, Florianópolis, SC, Brazil.
Acta Neurochir (Wien). 2021 Aug;163(8):2307-2311. doi: 10.1007/s00701-021-04855-7. Epub 2021 May 14.
The authors report a very rare case of bilateral occipital condyle fractures (OCF) that was associated with complete separation fracture of the inferior clivus resulting in craniocervical dislocation alongside dissociation of C1-C2 joint complex. Also, a new type of the Anderson and Montesano classification system is presented with two subtypes of injuries. Type IVA occurs when the OCF is associated a clivus avulsion fracture, while Type IVB occurs when the OCF is associated with complete "en piece" separation fracture of the inferior clivus. Both Type IV injuries are considered highly unstable, and surgical fixation is the recommended treatment option.
作者报告了一例极为罕见的双侧枕髁骨折（OCF），该骨折伴有斜坡下部完全分离骨折，导致颅颈脱位以及C1-C2关节复合体解离。此外，还提出了一种新型的安德森和蒙泰萨诺分类系统，该系统有两种损伤亚型。当枕髁骨折伴有斜坡撕脱骨折时为IVA型，而当枕髁骨折伴有斜坡下部完全“整块”分离骨折时为IVB型。IV型损伤均被认为高度不稳定，手术固定是推荐的治疗选择。
