Reaction of the Epiphysis to Partial Surgical Resection

¹ Department of Orthopaedic Surgery, Hospital of the University of Pennsylvania, Philadelphia

1. For the dangerous period between the time of injury and definitive treatment, and while being moved about during definitive treatment, the patient should be recumbent, at all times, on a firm stretcher or bed. An adjustable traction neck brace should be worn during these times, applied in the long axis of the spine in the neutral position.

2. Skull traction is the best proved means of protecting the cord during definitive treatment of cervical-spine injuries.

3. Skull traction will accomplish reduction and maintain it in a high proportion of injuries. It is comfortable and greatly facilitates nursing care.

4. Complete reduction is ideal; satisfactory reductions may include those in which there is less than 0.3 centimeter of decrease in the anteroposterior diameter of the vertebral canal. Open reduction was accomplished in seven patients, in six of whom skull traction had failed.

5. internal fixation and surgical fusion provide reliable stabilization of the injured vertebrae. They appear to protect the cord against attrition in patients with a vertebral-canal diameter of less than normal.

6. The treatment of cervical-spine injuries is highly specialized; technical errors in treatment may be fatal. A trained autd experienced operating team is essential.

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