Types of Occipital Condyle Fractures

Occipital condyle fractures can be classified based on of the form of applied strain developed by Anderson and Montesano:

• Type I: Comminuted impaction fracture due to axial loading
• Type II: Skull base fracture that extends through the occipital condyle
• Type III: Avulsion fracture mediated through tension in the alar ligament. May be associated with disruption of the alar ligaments and tectorial membrane and result in craniocervical dissociation.

Tuli et al. have also developed a system to guide neurosurgical management:

• Type 1: Nondisplaced occipital condyle fracture (stable). Require no specific treatment.
• Type 2A: Displaced occipital condyle fracture with intact ligaments. May be treated with a rigid collar.
• Type 2B: Displaced occipital condyle fracture with radiographic evidence of craniocervical junction instability. Require surgical instrumentation or halo traction

References

Hanson JA, Deliganis AV, Baxter AB, Cohen WA, Linnau KF, Wilson AJ, Mann FA. Radiologic and clinical spectrum of occipital condyle fractures: retrospective review of 107 consecutive fractures in 95 patients. AJR Am J Roentgenol. 2002 May;178(5):1261-8.