OCCIPITAL CONDYLAR FRACTURES - 14 OCCIPITAL CONDYLAR FRACTURES WITH INTRAVITAL DIAGNOSIS USING UNSELECTED CASES OF ACCIDENTS OVER 4 YEARS

Fractures of occipital condyles (OCF) are known since 1817 (4). Until the 1990ies, some 60 cases have been published. There are only a few references reporting on four to six own cases with intravital diagnosis (3, 5, 9, 13). The question is whether this is due to its rarity or whether there is a diagnostic gap at the craniocervical region. From 6/91-6/95 ail head injured patients underwent CT-scans of this region in addition to the routine procedures. An OCF was found in 14 cases. A typing was possible in modification of the literature (3): 3 x type I; 4 x type II; 4 x type ill, 3 x ''type IV''. One patient died on day 5. One ''type IV''-patient had to be operated because of a chronic epidural hematoma at the great foramen. Ail other patients were treated conservatively and showed a good outcome with some residual complaints locally. - OCFs are not so rare as supposed. OCF can be of significant importance if it occurs. Nothing is known on late effects in case of deformity of the great foramen by fragments (myelopathy?). - This is the hitherto largest series of OCF diagnosed in living patients.