PREOPERATIVE CLOSE REDUCTION OF CERVICAL FRACTURE DISLOCATIONS

Abstract

Study design: Retrospective study. Purpose: To determine Reduction rate of cervical fracture dislocations using preoperative gradual in hospital skull traction. Overview of literature: Cervical spine fracture dislocations are unstable injuries and require surgical intervention and stabilization. The approach may be anterior, posterior or combined. Majority of the surgeons prefer anterior approach after initial close reduction of cervical fracture dislocation. If close reduction preoperatively fails, then posterior direct reduction is needed followed by anterior surgery.In this study we intend to determine the rate of success (reduction) using preoperative gradual traction. Method: This retrospective study was conducted at Spine Unit Hayatabad Medical Complex and Aman hospital Peshawar. All patients with cervical fracture dislocations presented between Jan 2015 & Jan 2019, who underwent cervical traction prior to surgical interventions were included in the study. The demographics, types of dislocation, preoperative traction, duration and neurology of all patients were recorded. The success of reduction using closed in hospital gradual traction was assessed using lateral cervical spine x-rays. Data was assessed using SPSS version 20. Results: A total of 52 patients were included in the study with a mean age of 30.06 years (SD± 8.03). In 35(67.3%) patients the dislocation was bifacetal while in 17(32.7%) it was unifacetal. Successful reduction using gradual in hospital awake traction was achieved in 39(75%) patients while in 13(25%) patients reduction was not achieved. Mean duration of preoperative traction was 3.6 (SD±1.1) days with minimum 2 days and maximum 7 days. Conclusion: Gradual in hospital traction in awake patients is an effective mean of reducing cervical fracture dislocations.