THE TREATMENT OF FRACTURES AND FRACTURE DISLOCATIONS OF THE SPINE

The results of treatment of eighty cases of crush fracture of the spine by the author's method are reviewed. The method requires no special apparatus, no skilled assistance, no manipulation of the spine, and no anaesthetic.

Treatment is ambulatory throughout. The risk of lung complication and functional disorder is minimized. The method is equally applicable to the difficult high dorsal fractures, and to cervical fractures.

Comminuted fractures are easily reduced. They consolidate slowly and require six months' immobilization.

Fractures with paraplegia demand immediate reduction without anaesthesia. This routine has replaced laminectomy for spinal fracture. Recovery is secured in seventy per cent. of low dorsal and lumbar fractures, but is rarely seen in high dorsal fractures.

The only contra-indication to hyperextension treatment, is the very rare comminuted hyperextension fracture of the vertebral body.

Many fractures have undergone spontaneous reduction before being seen by the surgeon. After reduction they may be roentgenographically indistinguishable from normal. Herein lies the explanation of "Kümmell's disease".

Face-down transportation is essential in first aid treatment.

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