C-DISLOCATIONS OF THE VERTEBRAL COLUMN
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Jbic. 72.
several days. Only then should the paralysed bladder, which can be safely left without
any instrumentation for at least 24 hours, especially by a restricted intake of fluid, be
emptied. As pointed out in the Chapter on the bladder, this should be effected by inter
mittent catheterization with the 'non-touch' technique, as described previously, and should
be performed by a medical officer and not by para-medical first aiders.
THE INITIAL MANAGEMENT OF THE FRACTURED SPINE
Conservative treatment
The methods of conservative treatment as practised in ancient times until the beginning
of this century has been discussed in the chapter of Historical Background.
In the 2o's and 30*5 of this century, methods of reduction by hyperextension in prone
position were introduced, such as on slings, frames or hammock, as described by Davis
(1929) and Rogers (1930) or hanging (Bohler, 1935) and by Watson-Jones' two-table
method (1931, 1934). This was followed by application of plaster jackets extending from
the symphysis pubis below to the clavicles above. Dunlop & Parker (1933) hyperextended
the broken spine in supine position by the weight of head and trunk on one end and pelvis
and legs on the other with a padded sling which is placed transversely underneath the
fracture and held with a stirrup and lifted with block and tackle. However, Magnus (1931)
and his school renounced these methods of forceful reduction and, accepting the spinal
deformity, advocated consolidation of the fractured spine by placing the patient flat in
his bed in supine position with prolonged recumbency.
