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Anderson-Montesano Type III Occipital Condyle Fractures: Insights From a Multicenter Cohort.

Created on 17 Aug 2026

Authors

Ignacio Cirillo, Sebastián Blanco, Matias Harmat, Guillermo Ricciardi, Harold Sherman, Juan J Zamorano, Alfredo Guiroy

Published in

Clinical spine surgery. Jul 14, 2026. Epub Jul 14, 2026.

Abstract

Retrospective cohort study.
To describe a multicenter cohort of patients with type III occipital condyle avulsion fractures, emphasizing mechanical stability and treatment strategies.
Occipital condyle avulsion fractures are rare, potentially unstable, and historically underreported.
A retrospective study was performed across 4 spine centers, including patients with acute traumatic occipital condyle avulsion fractures treated between June 2017 and April 2024. Clinical and imaging variables were reviewed.
Thirty-two patients with Anderson-Montesano type III fractures were identified, predominantly male (81.3%), with a mean age of 36.6 years. High-energy trauma accounted for most cases (96.9%), mainly motor vehicle accidents (78.1%). Craniocervical instability was present in 9 patients (28.1%), all treated with posterior occipitocervical fusion; the remaining were managed nonoperatively. CT confirmed fusion in 20 patients (80%), with a mean healing time of 99.2 days. Median follow-up was 702 days. Instability was significantly associated with severe head trauma, unstable C1-C2 injuries, and MRI-documented ligamentous or soft tissue injury.
Most occipital condyle avulsion fractures are stable and suitable for conservative management, but a relevant subset demonstrates craniocervical instability requiring surgical stabilization. MRI and dynamic radiographs help identify high-risk cases.

PMID:
42606359
Bibliographic data and abstract were imported from PubMed on 17 Aug 2026.

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