Fracture-dislocation of the thoracic and lumbar spine: advantages of halo-bifemoral traction.

Thoracic and lumbar fracture-dislocations with 100% spinal column displacement are uncommon injuries that usually have associated neurologic injury. Severe spinal malalignment and instability can result in blood loss, tenting of skin and, severe pain. Four patients with thoracic or lumbar fracture-dislocations were initially treated and reduced with halo-bifemoral traction. Fracture reduction with halo-bifemoral traction decreased pain, controlled instability, relieved skin pressure, and prevented the need for acute surgical intervention. In addition, use of halo-bifemoral traction allowed for the resolution of spinal shock, allowed time for complete presurgical planning, and simplified the reduction portion of the operative procedure, thereby reducing operative time and blood loss.