APPLICATION OF MODIFIED TRACTION ARCH OF SKULL IN SKULL TRACTION_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

LEIXing ¹ , WANGHuan ² , SONGYang ³ ,  QUYanlong ²

1. Department of Orthopedics, Linyi People's Hospital, Linyi Shandong, 276000, P. R. China;
2. Department of Orthopedics, the First Hospital Affiliated to Harbin Medical University;
3. Department of Orthopedics, the Second Hospital Affiliated to Harbin Medical University;

Corresponding author：

QUYanlong, Email: qyl-24@163.com

Keywords：

Skull traction; Modified traction arch of skull; Traction arch slippage

DOI：

10.7507/1002-1892.20140319

Video：

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Objective To investigate the feasibil ity and effectiveness of the modified traction arch of skull (crossbar traction arch) for skull traction in treating cervical spine injury by comparing with traditional traction arch of skull. Methods Between June 2009 and June 2013, 90 patients with cervical vertebrae fractures or dislocation were treated with modified skull traction surgery (trial group, n=45) and traditional skull traction surgery (control group, n=45). There was no significant difference in gender, age, injury types, injury level, the interval between injury and admission, and Frankel grading of spinal injury between 2 groups (P>0.05). The cl inical efficacy was evaluated after operation by the indexes such as traction arch sl i ppage times, operation time, the infection incidence of the pin hole, incidence of skull perforation, visual analogue scale (VAS), and reduction status of cervical dislocation. Results The traction arch slippage times, the infection incidence of the pin hole, operation time, blood loss, and postoperative VAS score in trial group were significantly lower than those in control group (P<0.05). There was no significant difference in the incidence of skull perforation caused by clamp crooks of traction arch between 2 groups (P=1.000). At 2 weeks after operation, the patients had no headaches, infections, or other complications in 2 groups. In patients with cervical dislocation, 4 of the trial group and 6 of the control group failed to be reset, the reduction rate was 83.33% (20/24) and 68.42% (13/19) respectively, showing no significant difference (χ²=0.618, P=0.432). Conclusion The operation with modified traction arch of skull has significant advantages to reduce postoperative complication compared with tradition traction arch of skull.

Citation： LEIXing, WANGHuan, SONGYang, QUYanlong. APPLICATION OF MODIFIED TRACTION ARCH OF SKULL IN SKULL TRACTION. Chinese Journal of Reparative and Reconstructive Surgery, 2014, 28(12): 1474-1478. doi: 10.7507/1002-1892.20140319 Copy

1.	Goni V, Gopinathan NR, Krishnan V, et al. Management of neglected cervical spine dislocation:a study of six cases. Chin J Traumatol, 2013, 16(4):212-215.
2.	Odebode TO, Agaja SB. Odebode-Agaja adult cervical traction device. Trop Doct, 2011, 41(1):21-22.
3.	Qureshi MA, Afzal W, Khalique AB, et al. Tuberculosis of the craniovertebral junction. Eur Spine J, 2013, 22 Suppl 4:612-617.
4.	肖强, 熊龙, 喻惜华, 等. 改良Gardner-Wells颅骨牵引器在颈椎外科中的应用. 中华创伤杂志, 2007, 23(9):712-713.
5.	Kosnik-Infinger L, Glazier SS, Frankel BM. Occi pital condyle to cervical spine fixation in the pediatric population. J Neurosurg Pediatr, 2014, 13(1):45-53.
6.	Riouallon G, Pascal-Moussellard H. Atlanto-axial dislocation complicating a type Ⅱ odontoid fracture. Reduction and final fixation. Orthop Traumatol Surg Res, 2014, 100(3):341-345.
7.	金建华. 颅骨牵引弓钳钩尖刺入颅内引起硬脑膜下大出血一例报告. 中华骨科杂志, 2001, 21(8):467.
8.	Soyer J, Iborra JP, Fargues P, et al. Brain abscess following the use of skull traction with Gardner-Wells tongs. Chirurgie, 1999, 124(4):432-434.
9.	Nimityongskul P, Bose WJ, Hurley DP Jr, et al. Superficial temporal artery laceration. A compl ication of skull tong traction. Orthop Rev, 1992, 21(6):761, 764-765.
10.	Gruenberg MF, Rechtine GR, Chrin AM, et al. Overdistraction of cervical spine injuries with the use of skull traction:a report of two cases. J Trauma, 1997, 42(6):1152-1156.
11.	Horsley M, Taylor TK, Sorby WA. Traction-induced rupture of an extracranial vertebral artery aneurysm associated with neurofibromatosis. A case report. Spine (Phila Pa 1976), 1997, 22(2):225-227.
12.	Lauweryns P. Role of conservative treatment of cervical spine injuries. Eur Spine J, 2010, 19 Suppl 1:S23-26.
13.	陈科, 靳安民. 颅骨牵引治疗下颈椎脱位伴关节突交锁的研究进展. 中国脊柱脊髓杂志, 2011, 21(12):1022-1025.
14.	贺立新, 昌宏, 尚旭亚. 颅骨牵引钉滑脱致颞部皮肤坏死1例的教训. 解放军护理杂志, 2004, 21(11):15.
15.	柏树令. 系统解剖学. 6版. 北京:人民卫生出版社, 2005:258-259.
16.	Chumbley CC, Hutchings RT. 人体实地解剖彩色图谱. 2版. 杨琳, 主译. 北京:人民卫生出版社, 1994:181.
17.	王怀经, 张绍祥. 局部解剖学. 2版. 北京:人民卫生出版社, 2011:9.
18.	Basu S, Mal ik FH, Ghosh JD, et al. Delayed presentation of cervical facet dislocations. J Orthop Surg (Hong Kong), 2011, 19(3):331-335.

1. Goni V, Gopinathan NR, Krishnan V, et al. Management of neglected cervical spine dislocation:a study of six cases. Chin J Traumatol, 2013, 16(4):212-215.
2. Odebode TO, Agaja SB. Odebode-Agaja adult cervical traction device. Trop Doct, 2011, 41(1):21-22.
3. Qureshi MA, Afzal W, Khalique AB, et al. Tuberculosis of the craniovertebral junction. Eur Spine J, 2013, 22 Suppl 4:612-617.
4. 肖强, 熊龙, 喻惜华, 等. 改良Gardner-Wells颅骨牵引器在颈椎外科中的应用. 中华创伤杂志, 2007, 23(9):712-713.
5. Kosnik-Infinger L, Glazier SS, Frankel BM. Occi pital condyle to cervical spine fixation in the pediatric population. J Neurosurg Pediatr, 2014, 13(1):45-53.
6. Riouallon G, Pascal-Moussellard H. Atlanto-axial dislocation complicating a type Ⅱ odontoid fracture. Reduction and final fixation. Orthop Traumatol Surg Res, 2014, 100(3):341-345.
7. 金建华. 颅骨牵引弓钳钩尖刺入颅内引起硬脑膜下大出血一例报告. 中华骨科杂志, 2001, 21(8):467.
8. Soyer J, Iborra JP, Fargues P, et al. Brain abscess following the use of skull traction with Gardner-Wells tongs. Chirurgie, 1999, 124(4):432-434.
9. Nimityongskul P, Bose WJ, Hurley DP Jr, et al. Superficial temporal artery laceration. A compl ication of skull tong traction. Orthop Rev, 1992, 21(6):761, 764-765.
10. Gruenberg MF, Rechtine GR, Chrin AM, et al. Overdistraction of cervical spine injuries with the use of skull traction:a report of two cases. J Trauma, 1997, 42(6):1152-1156.
11. Horsley M, Taylor TK, Sorby WA. Traction-induced rupture of an extracranial vertebral artery aneurysm associated with neurofibromatosis. A case report. Spine (Phila Pa 1976), 1997, 22(2):225-227.
12. Lauweryns P. Role of conservative treatment of cervical spine injuries. Eur Spine J, 2010, 19 Suppl 1:S23-26.
13. 陈科, 靳安民. 颅骨牵引治疗下颈椎脱位伴关节突交锁的研究进展. 中国脊柱脊髓杂志, 2011, 21(12):1022-1025.
14. 贺立新, 昌宏, 尚旭亚. 颅骨牵引钉滑脱致颞部皮肤坏死1例的教训. 解放军护理杂志, 2004, 21(11):15.
15. 柏树令. 系统解剖学. 6版. 北京:人民卫生出版社, 2005:258-259.
16. Chumbley CC, Hutchings RT. 人体实地解剖彩色图谱. 2版. 杨琳, 主译. 北京:人民卫生出版社, 1994:181.
17. 王怀经, 张绍祥. 局部解剖学. 2版. 北京:人民卫生出版社, 2011:9.
18. Basu S, Mal ik FH, Ghosh JD, et al. Delayed presentation of cervical facet dislocations. J Orthop Surg (Hong Kong), 2011, 19(3):331-335.

Chinese Journal of Reparative and Reconstructive Surgery

APPLICATION OF MODIFIED TRACTION ARCH OF SKULL IN SKULL TRACTION

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