In message <[log in to unmask]
osp-tr.wmids.nhs.uk>, Dunn Matthew Dr. (RJC) ACCIDENT & EMERGENCY -
SwarkHosp-TR <[log in to unmask]> writes
>Not uncommon to see patients with cervical spine injuries walking in. The
>C5/6 unifacet dislocation is a pretty common one and very stable (if you've
>ever tried reducing one of these it takes a reasonable amount of force to do
>even with muscles relaxed)- another important point on spinal injuries
>though- not only are they fairly uncommon but a lot of them are stable.
>I agree that there is an issue with risk/ benefit for 'spinal
>immobilisation'. It is generally held to be a good thing. However there is
>no clear evidence for its benefit even in patients with unstable spinal
>injuries (I am prepared to be corrected on this one); it will clearly have
>no benefit in the rest (the vast majority) and it had unquantified risk.
>Scope here for further primary and secondary research and subsequent
>evidence based challenge to the orthodoxy.
>
>
The sticking point is "who is delivering the service?". Can all of us
honestly predict which injuries are stable?
--
Stephen Hughes 'Arlow
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