DISLOCATION OF TIIE LOWER CER VICAL VERTEBR
The mechanism of the unilateral for ward and bilateral dislocations in op posite directions is abduction (lateral flexion) and rotation, by which the in ferior articular process of the upper ver tebra is lifted over the superior process of the lower one. Bilateral forward dislo
cations are caused by hyperflexion, back ward by hyperextension and direct press ure.
Treatment.—Reduction should be at tempted at once. Unilateral dislocations are to be reduced in the way they were produced; i.e., by abduction and rota tion, aided by direct manipulation, so as to lift the disarticulated bone back into place.
Traction and local pressure have proved effectual in the reduction of bi lateral dislocations.
After the reduction the patient should be kept quiet for some weeks. A plaster of-Paris splint for head and neck is ad visable.
These means failing, if there seems any hope of recovery by renewing the pressure from the cord, the dislocation should be cut down upon aseptically and an attempt made to reduce it by remov ing such ligamentous or bony obstacles as may exist.