[Diagnostic problems in fractures of the occipital condyles]

Three cases involving fractures of the occipital condyle were recently treated by the authors. Since plain radiographs of the upper cervical spine often fail to reveal this lesion, it can be difficult to diagnose. It seems to be more common than previously suspected and described. We found one axial compression fracture and two avulsion fractures with different degrees of atlanto-occipital instability. Mandibular fracture occurred in all cases. There was no severe craniocervical trauma. The atlanto-occipital junction should always be included in the CT evaluation of facial or craniocervical trauma. Thin-section CT of the craniocervical region can best visualize this fracture and should be used when it is suspected. All cases were treated by orthotic immobilisation.