February 28, 1972

Reduction of Locked Facets

JAMA. 1972;219(9):1212. doi:10.1001/jama.1972.03190350048022

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To the Editor.—  In the FRACTURE OF THE MONTH (218:1288, 1971), I was particularly interested in the application of traction for reduction of locked facets. The angle of traction used was direct axial pull.It has been my experience that individuals with this condition can be recognized in the emergency room because they, unlike persons with cervical fracture dislocations without locked facets, are uncomfortable in hyperextension, and are more comfortable in flexion. I believe the reason for this is that when hyperextension is carried out, they have less room for their spinal cords. In addition, perhaps they squeeze their nerve roots a bit.Historically, the older method of rapid reduction of cervical dislocations was carried out with the leather head halter, the leather belt, and manual pressure on the shoulders with first flexion, then traction, then hyperextension.The method I have used since 1939 has been to place the patient