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46 NORTH CAROLINA MEDICAL JOURNAL February, 1944 Fig. 7. Hyperextension by use of an auto inner tube, for treatment or transportation on the ambulance. principle—hyperextension and, in some cases, traction. Some surgeons advocate reduction and the application of a plaster jacket as soon as possible for thoracic and lumbar fractures; others maintain hyperextension in other ways and postpone the application of plaster until later(4). Our routine at the Woodard-Herring Hospital is as follows: (1) The patient is placed in an ordinary adjustable hospital bed, with his head at the foot of the bed (fig. 8). (2) The foot of the bed is elevated. The break in the bed that ordinarily lifts the knees will be under the lumbar or thoracic region. In this way complete hyperextension is obtained, and, to be effective, hyperextension must be complete. The crushed fragments of bone are drawn into position by the longitudinal ligament, and the torn ends of the posterior ligaments are approximated. It is the last few degrees of extension which actually produce reduction^. If a hospital bed is not available, one half of a six inch automobile inner tube placed under the spine and inflated gives excellent results (fig. 7). (3) After thirty days these patients are put on a Goldthwaite frame and a plaster jacket is fitted. They are advised to wear this jacket for two or three months, at the end of which time a back brace such as a Taylor brace is supplied. This brace should be worn during the day for a period ranging from one to three months. The patient should be advised to remove it at night and take exercises. Wearing a brace too long a time without exercise will cause muscular atrophy and osteoporosis, or bone atrophy of the vertebrae. 4. Wilson, Philip D. (Ed.): Experience in the Management of Fractures and Dislocations, Philadelphia, J. B. Lippin-cott, 1938. Fig. 8. Hyperextension obtained by placing the patient's head at the foot of an adjustable hospital bed and elevating the foot of the bed. Treatment of Cervical Injuries Fractures of the cervical vertebrae (fig. 9) are treated in almost the same manner, except that traction and manipulation are always used in addition to hyperextension. Traction is the most important part of the treatment. Many ways have been devised for maintaining traction in cases of broken necks, but in my opinion the Crutchfield tongs are the simplest and most practical method and give the best results. The technique of their use is as follows: The tongs are applied transversely to the vertex of the skull in a vertical plane pass- Fig. 9. Fracture-dislocation of the second and third cervical vertebrae.
Object Description
Rating | |
Fixed Title * | NCHH-17: North Carolina Medical Journal [1940-2001] |
Document Title | North Carolina Medical Journal [1940-2001] |
Subject Topical Other | Public Health -- Periodicals.; Physicians -- North Carolina -- Directory.; Societies, Medical -- North Carolina -- Periodicals. |
Description | Includes Transactions of the Society, -1960; 1961- , Transactions issued separately, bound in.; Includes Transactions of the auxiliary to the Medical Society of the State of North Carolina and Proceedings of the North Carolina Public Health Association. Official organ of the Medical Society of the State of North Carolina, 1940-May 1972; of the North Carolina Medical Society, June 1972-. Vols. for 1940-May 1972 published by the Medical Society of the State of North Carolina; June 1972- by the North Carolina Medical Society. |
Contributor | Medical Society of the State of North Carolina. Transactions.; Medical Society of the State of North Carolina.; North Carolina Medical Society.; North Carolina Medical Society. Transactions.; North Carolina Public Health Association. Proceedings. |
Publisher | [Winston-Salem] : North Carolina Medical Society [etc.], 1940- |
Repository | University of North Carolina at Chapel Hill. Health Sciences Library. |
Host | University of North Carolina at Chapel Hill |
Date | 1944 |
Identifier | NCHH-17-005 |
Form General | Periodicals |
Language | English |
Rights | This item is part of the North Carolina History of Health Digital Collection. Some materials in the Collection are protected by U.S. copyright law. This item is presented by the Health Sciences Library of the University of North Carolina at Chapel Hill for research and educational purposes. It may not be republished or distributed without permission of the Health Sciences Library. |
Digital Collection | North Carolina History of Health Digital Collection |
Sponsor | The North Carolina History of Health Digital Collection is an open access publishing initiative of the Health Sciences Library of the University of North Carolina at Chapel Hill. Financial support for the initiative was provided in part by a multi-year NC ECHO (Exploring Cultural Heritage Online) digitization grant, awarded by the State Library of North Carolina, and funded through the Library Services and Technology Act (LSTA). |
Volume Number | 5 |
Health Discipline | Medicine |
Digital Format | JPEG 2000 |
Print / Download PDF Version | http://archives.hsl.unc.edu/nchh/nchh-17/nchh-17-005.pdf |
Document Sort | all; nchh-17 |
Volume Link | http://dc.lib.unc.edu/cdm/search/collection/nchh/field/identi/searchterm/NCHH-17-005 |
Title Link | http://dc.lib.unc.edu/cdm/search/collection/nchh/field/documa/searchterm/NCHH-17 |
Catalog Record link | http://search.lib.unc.edu/search?R=UNCb1306322 |
Revision History | done |
Description
Fixed Title * | Page 46 (images) |
Document Title | North Carolina Medical Journal [1940-2001] |
Subject Topical Other | Public Health -- Periodicals.; Physicians -- North Carolina -- Directory.; Societies, Medical -- North Carolina -- Periodicals. |
Description | Includes Transactions of the Society, -1960; 1961- , Transactions issued separately, bound in.; Includes Transactions of the auxiliary to the Medical Society of the State of North Carolina and Proceedings of the North Carolina Public Health Association. Official organ of the Medical Society of the State of North Carolina, 1940-May 1972; of the North Carolina Medical Society, June 1972-. Vols. for 1940-May 1972 published by the Medical Society of the State of North Carolina; June 1972- by the North Carolina Medical Society. |
Contributor | Medical Society of the State of North Carolina. Transactions.; Medical Society of the State of North Carolina.; North Carolina Medical Society.; North Carolina Medical Society. Transactions.; North Carolina Public Health Association. Proceedings. |
Publisher | [Winston-Salem] : North Carolina Medical Society [etc.], 1940- |
Repository | University of North Carolina at Chapel Hill. Health Sciences Library. |
Host | University of North Carolina at Chapel Hill |
Date | 1944 |
Identifier | NCHH-17-005-0054 |
Form General | Periodicals |
Page Type | all; all images; photo; all images; x-ray; article |
Language | English |
Rights | This item is part of the North Carolina History of Health Digital Collection. Some materials in the Collection are protected by U.S. copyright law. This item is presented by the Health Sciences Library of the University of North Carolina at Chapel Hill for research and educational purposes. It may not be republished or distributed without permission of the Health Sciences Library. |
Filename | northcarolinamed51944medi_0054.jp2 |
Digital Collection | North Carolina History of Health Digital Collection |
Sponsor | The North Carolina History of Health Digital Collection is an open access publishing initiative of the Health Sciences Library of the University of North Carolina at Chapel Hill. Financial support for the initiative was provided in part by a multi-year NC ECHO (Exploring Cultural Heritage Online) digitization grant, awarded by the State Library of North Carolina, and funded through the Library Services and Technology Act (LSTA). |
Volume Number | 5 |
Issue Number | 2 |
Page Number | 46 |
Health Discipline | Medicine |
Full Text | 46 NORTH CAROLINA MEDICAL JOURNAL February, 1944 Fig. 7. Hyperextension by use of an auto inner tube, for treatment or transportation on the ambulance. principle—hyperextension and, in some cases, traction. Some surgeons advocate reduction and the application of a plaster jacket as soon as possible for thoracic and lumbar fractures; others maintain hyperextension in other ways and postpone the application of plaster until later(4). Our routine at the Woodard-Herring Hospital is as follows: (1) The patient is placed in an ordinary adjustable hospital bed, with his head at the foot of the bed (fig. 8). (2) The foot of the bed is elevated. The break in the bed that ordinarily lifts the knees will be under the lumbar or thoracic region. In this way complete hyperextension is obtained, and, to be effective, hyperextension must be complete. The crushed fragments of bone are drawn into position by the longitudinal ligament, and the torn ends of the posterior ligaments are approximated. It is the last few degrees of extension which actually produce reduction^. If a hospital bed is not available, one half of a six inch automobile inner tube placed under the spine and inflated gives excellent results (fig. 7). (3) After thirty days these patients are put on a Goldthwaite frame and a plaster jacket is fitted. They are advised to wear this jacket for two or three months, at the end of which time a back brace such as a Taylor brace is supplied. This brace should be worn during the day for a period ranging from one to three months. The patient should be advised to remove it at night and take exercises. Wearing a brace too long a time without exercise will cause muscular atrophy and osteoporosis, or bone atrophy of the vertebrae. 4. Wilson, Philip D. (Ed.): Experience in the Management of Fractures and Dislocations, Philadelphia, J. B. Lippin-cott, 1938. Fig. 8. Hyperextension obtained by placing the patient's head at the foot of an adjustable hospital bed and elevating the foot of the bed. Treatment of Cervical Injuries Fractures of the cervical vertebrae (fig. 9) are treated in almost the same manner, except that traction and manipulation are always used in addition to hyperextension. Traction is the most important part of the treatment. Many ways have been devised for maintaining traction in cases of broken necks, but in my opinion the Crutchfield tongs are the simplest and most practical method and give the best results. The technique of their use is as follows: The tongs are applied transversely to the vertex of the skull in a vertical plane pass- Fig. 9. Fracture-dislocation of the second and third cervical vertebrae. |
Digital Format | JPEG 2000 |
Print / Download PDF Version | http://archives.hsl.unc.edu/nchh/nchh-17/nchh-17-005.pdf |
Document Sort | all; nchh-17 |
Article Title | What The Practitioner Should Know About Spine Injuries |
Article Author | M. A. Pittman |
Volume Link | http://dc.lib.unc.edu/cdm/search/collection/nchh/field/identi/searchterm/NCHH-17-005 |
Title Link | http://dc.lib.unc.edu/cdm/search/collection/nchh/field/documa/searchterm/NCHH-17 |
Catalog Record link | http://search.lib.unc.edu/search?R=UNCb1306322 |
Revision History | done |
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