FRACTURES, DISLOCATIONS, AND FRACTURE-DISLOCATIONS OF THE SPINE

Abstract

1 have chosen the subject of injuries to the vertebral column because it is one that has interested Watson-Jones for many years, and one upon which he has written extensively. Indeed it was his writings which stimulated me to study vertebral injuries, especially those associated with paraplegia. I am pleased to be able in this paper to pay tribute to him as a great surgeon who is also a great personal friend. Thirty years ago Watson Jones (1931), following the work of Davis (1929), published a classification of fractures of the spine together with a method of treatment of what were considered to be pure flexion fractures, whereby the fracture was reduced by hyperextension, position being maintained by fixation ofthe spine in plaster in hyperextension for many weeks. He stated that accurate reduction was almost always possible, that consolidation occurred without deformity, and that provided exercise in plaster was properly performed the functional results were excellent. My experience of the treatment of vertebral fractures did not confirm this. I found that in a considerable proportion of patients the displacement could not be reduced by hyperextension, and that even if good position was obtained it could not be maintained by