Department of Orthopaedic Surgery - University Stellenbosch, South Africa
|Cervical Traction||Next Page >>|
Halter traction is used for short term cervical traction. Uses include
minor neck injuries without obvious fractures e.g. Whiplash injury, neck
muscle spasm, conservative treatment of cervical disk lesions.
Flexion Extension cervical X-rays
If a patient has normal cervical X-rays, but has neck muscle spasm Flexion Extension views may be needed to exclude serious instability of the cervical spine. Halter traction is a good way to relieve the spasm before these X Rays can be done. The patient is admitted and placed in Halter traction until the neck is free of muscular spasm. Under direct supervision of the attending doctor the flexion extension views are taken in the X ray department. The patient must have no pain when the neck is flexed and extended. If neurological symptoms such as parasthesia develop the X rays are abandoned.
In more serious cervical injuries skull tongs such as Cones calipers are indicated. Indications include the conservative treatment of cervical fractures and dislocations.
*(Each uninvolved vertebra cephalad)
The double mattress method is an effective way to extend the neck. Never
place the head pulley too low as a pressure sore can result on the occiput,
especially in the unconscious or neurologically compromised patient.
Reduction of Facet dislocations
Skeletal traction to the skull can be used to reduce cervical facet dislocations Weights are serially added while the neck is positioned in flexion After each 2.5kg weight is added a lateral X ray is taken to determine reduction. The attending doctor checks for neurological signs. If neurology deteriorates the weights are removed. Up to 20 kg. traction may be used in this way for a few hours only. After reduction the neck is placed in extension and the lighter maintenance weights are used.