Definitive management - general principles

The general principles involved in the management of spinal fractures are as follows;

• stable fractures are left as they are and the patient supported with the spine in a position that will not cause further strain
  
  
• subluxations and dislocations are reduced by either postural adjustment, traction (with a 'Halo' screwed to the skull) or open reduction
  
  
• unstable fractures should be securely held, in the cervical spine by traction, and in the lumbar region by immobilisation in an appropriate position, until the soft tissues heal and the spine becomes stable; internal or external fixation may be necessary