Ryszard Tomaszewski1,2, Jacek Kler3, Karol Pethe3, Agnieszka Zachurzok4. 1. Department of Pediatric Traumatology and Orthopedy, Upper Silesian Child Centre in Katowice, 40-752 Katowice ul. Medyków, 16, Katowice, Poland. tomaszewskir@gmail.com. 2. Faculty of Science and Technology, Institute of Biomedical Engineering, University of Silesia, Katowice, Poland. tomaszewskir@gmail.com. 3. Department of Pediatric Traumatology and Orthopedy, Upper Silesian Child Centre in Katowice, 40-752 Katowice ul. Medyków, 16, Katowice, Poland. 4. Department of Pediatrics and Pediatric Endocrinology, School of Medicine in Katowice, Medical University of Silesia, Katowice, Poland.
Abstract
BACKGROUND: Occipital condyle fractures (OCFs) in patients before 18 years of age are rare. Classifications of OCF are based on the CT images of the cranio-cervical junction (CCJ) and MRI. The Anderson-Montesano and Tuli classifications are the types which are most commonly used in these cases. Classification of OCFs allows the implementation of OCF treatment. The aim of this study was to evaluate the effectiveness of using the OCF classification in pediatric patients based on the analysis of our own cases. METHODS: During the years 2013-2020, 6 pediatric patients with OCFs, aged 14-18, have been treated. Two patients with unstable fracture III according to Anderson-Montesano and IIB according to Tuli were treated with the halo-vest. Additionally, one patient presenting neurological symptoms and with an associated C1 fracture was qualified for the halo-vest stabilization as well. The other patients were treated with a Minerva collar. We evaluated the results 6 months after completing the OCF treatment using the Neck Disability Index (NDI) and SF-36 questionnaires. Confidence intervals for the mean values were verified using the MeanCI function (from the R library DescTools) for both classical and bootstrap methods. RESULTS: Based on NDI results, we have obtained in our patients an average of 4.33/45 points (2-11) and 9.62% (4.4-24.4). Based on the SF-36 questionnaire, we obtained an average of 88.62% (47.41-99.44). CONCLUSION: The Anderson-Montesano and Tuli's classifications of OCF can be used to assess the stability of OCF in adolescents, but both classifications should be used simultaneously. CT and MR imaging should be used in diagnosing OCFs, whereas CT allows assessing therapeutic outcomes in OCF.
BACKGROUND:Occipital condyle fractures (OCFs) in patients before 18 years of age are rare. Classifications of OCF are based on the CT images of the cranio-cervical junction (CCJ) and MRI. The Anderson-Montesano and Tuli classifications are the types which are most commonly used in these cases. Classification of OCFs allows the implementation of OCF treatment. The aim of this study was to evaluate the effectiveness of using the OCF classification in pediatric patients based on the analysis of our own cases. METHODS: During the years 2013-2020, 6 pediatric patients with OCFs, aged 14-18, have been treated. Two patients with unstable fracture III according to Anderson-Montesano and IIB according to Tuli were treated with the halo-vest. Additionally, one patient presenting neurological symptoms and with an associated C1 fracture was qualified for the halo-vest stabilization as well. The other patients were treated with a Minerva collar. We evaluated the results 6 months after completing the OCF treatment using the Neck Disability Index (NDI) and SF-36 questionnaires. Confidence intervals for the mean values were verified using the MeanCI function (from the R library DescTools) for both classical and bootstrap methods. RESULTS: Based on NDI results, we have obtained in our patients an average of 4.33/45 points (2-11) and 9.62% (4.4-24.4). Based on the SF-36 questionnaire, we obtained an average of 88.62% (47.41-99.44). CONCLUSION: The Anderson-Montesano and Tuli's classifications of OCF can be used to assess the stability of OCF in adolescents, but both classifications should be used simultaneously. CT and MR imaging should be used in diagnosing OCFs, whereas CT allows assessing therapeutic outcomes in OCF.
Authors: Antonio Krüger; Ludwig Oberkircher; Thomas Frangen; Steffen Ruchholtz; Christian Kühne; Andreas Junge Journal: J Craniovertebr Junction Spine Date: 2013-07