Emergency War Surgery NATO Handbook: Part IV: Regional Wounds and Injuries: Chapter XXXIII: Wounds and Injuries of the Spinal Column and Cord
United States Department of Defense
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Reviewed
Skeletal traction using Gardner-Wells skull tongs is the treatment of choice for the reduction and stabilization of cervical spine injuries (Figure 45, Table 18). While a halter or chin strap may be temporarily utilized during the initial evacuation, they are not satisfactory for long-term use.
When cranial tongs are used for traction, the rule of thumb for determining the amount of weight to be applied to the tongs for fracture reduction is 5 lbs. per level of injury. For example, to reduce a C-5 fracture, you would begin with 25 lbs. of weight. If this is insufficient weight to achieve reduction, appropriate additional increments of weight can be successively applied every 20-30 minutes under radiological control until reduction is attained. The maximal amount of weight that can be safely applied to properly placed Gardner-Wells tongs is 80-90 lbs.
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