First :-Many fracture-crushes of the spine, without cord involvement, are unrecognized. A great many physicians think that if a man can walk he has not fractured his spine, and treat him for sprains and contusions of the soft parts.
Second :-The majority of fracture-crushes of the spine receive no adequate treatment. They are allowed up after periods of from one to eight weeks in bed without any support and gradually break down and deform. It is highly essential, no matter how long patient has been in bed. that he have adequate support in order to restore, partially at least, the normal function of the spine, while at the same time preventing the occurrence of deformity until the return of full function is permissible.
Third :-We have found that the spinous processes of the fractured vertebrae will be tender until the healing of the vertebra has taken place and all strain has been taken from it.
Fourth :-It is very easy to fracture a vertebra if weight is applied to the top of a slightly flexed spine.
Fifth :-All cases of fractured spine should be corrected and put in the best position and then held in that position until nature has repaired it. This should be at least six months.
Sixth :-It is unnecessary to do any operation on the spine for internal fixation.
Seventh :-Every case of suspected fracture of the spine should have a thorough x-ray examination, and that means plates taken antero-posteriorly and laterally.
(C) 1923 All Rights Reserved.The Journal of Bone and Joint Surgery, Inc.