Halter traction for cervical spine injuries - initial treatment in the district hospital.

Cervical halter traction has been a method of gentle traction used in home care settings for selected patients with cervical radiculopathy. An active management program with cervical halter traction was initiated for patients with cervical spine injury admitted to Choma General Hospital in Zambia during the years 2000–2009. The surgical consultant on call was available to assist with early radiologic evaluations. We were able to identify 15 patients in this period with cervical spine injury. Most of these injuries were from low-speed bicycle injury, some from porter injuries, some from higher impact road traffic accidents. The common areas identified were C5 and C6 injuries. The bony injuries were fracture, subluxation, or facet dislocation. The neurologic injuries were radiculopathy and central cord syndrome. The mechanisms of injury were compressive flexion or lateral flexion. Although traction has sometimes been associated with secondary neurologic injury we did not observe this complication. Our patients had these injuries as isolated injuries without significant additional chest, abdominal, or extremity injury. After early application of traction, followup portable X-ray films were obtained. Weights were reduced after 1 week. Patients were discharged at 4 weeks with soft neck collars.