![]() Any occipital condylar fracture associated with craniocervical dissociation is unstable.Ĭraniocervical dissociation is considered unstable with translation or distraction > 2 mm in any plane. Type 3 fractures are unstable avulsion injuries secondary to rotation and lateral bending, presenting with a transverse fracture line through the occipital condyle ( Fig. ![]() Type 2 injuries are potentially unstable injuries caused by a shear mechanism that results in an oblique fracture extending from the condyle into the skull base. Type 1 is an impacted comminuted condylar fracture with minimal displacement secondary to axial loading. Occipital condyle fractures were classified into three types by Anderson and Montesano. Differentiation between stable and unstable cervical spine injuries is of utmost importance ( Table 15.5). Cervical (C) spine injuries are caused by hyperflexion (e.g., anterior wedge or compression fracture, teardrop fracture, anterior subluxation, and bilateral jumped facets with anterior subluxation of the superior vertebra), hyperextension (e.g., avulsion anteroinferior corner of a vertebral body, typically at C2, or C3, and hangman’s fracture), hyperrotation (e.g., rotary atlantoaxial subluxation), hyperflexion and rotation (e.g., unilateral jumped facet), lateral hyperflexion (e.g., unilateral pillar fracture), and vertical compression (e.g., Jefferson fracture and burst fractures C3–C7).
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