Some cervical dislocation injuries may be acutely treated with traction via Gardner-Wells tongs, which are attached to the skull via two pins. While a variety of techniques have been proposed and utilized in the literature and clinical practice to use the tongs, these techniques have not been methodically studied to confirm how they transmit loads to the cervical spine. The current study investigated the mechanical effect of different traction techniques in a laboratory setting. A 50th male Hybrid anthropomorphic test device was used as a human surrogate to represent an average male in height and weight was modified to represent a patient with a unilateral facet dislocation injury. Electronic sensors at the atlanto-occipital joint recorded the loading delivered to the superior cervical spine by traction loading. Combinations of the following variables were evaluated as traction loads were progressively increased to one-third of body weight: tong pin position in the skull (anterior-posterior and superior-inferior to the recommended neutral position), traction cable angle in the sagittal plane (elevated, horizontal, declined), and presence or absence of an occipital support. Analysis of the cervical axial traction loads showed that the only significant predictor of cervical tension was the magnitude of the traction load. Anterior-posterior changes in the pin positions in the skull significantly influenced the cervical flexion-extension moment and anterior-posterior (AP) shear. The data show that a combined cervical tension, flexion moment, and anterior shear force can be achieved with posteriorly biased pins and a bolster behind the head. Increasing the angle of traction cable increased the cervical flexion moment and anterior shear force. The following variables should be carefully considered when applying cervical traction since they significantly affect cervical loading: magnitude of the hanging traction load, anterior-posterior pin position, use of an occipital bolster, and traction load angle.

中文翻译：

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牵引过程中的牵引负荷，钳位和头部支撑会显着影响颈椎负荷。

可以通过Gardner-Wells钳进行牵引，以治疗一些子宫颈脱位的损伤，该钳通过两个销钉固定在颅骨上。尽管已经提出了多种技术并在文献和临床实践中使用了这种钳子，但是尚未对这些技术进行系统地研究以确认它们如何将负荷传递到颈椎。当前的研究在实验室环境中研究了不同牵引技术的机械作用。将第50个男性Hybrid拟人化测试设备用作人类替代品，以代表平均身高的男性，并对体重进行修改，以代表患有单侧小关节脱位损伤的患者。寰枕关节处的电子传感器记录了通过牵引载荷传递至上颈椎的载荷。当牵引力逐渐增加到体重的三分之一时，评估了以下变量的组合：颅骨上的钳子位置（在推荐的中性位置的前后位置和上下位置），矢状面的牵引索角度（高，水平，下降），以及是否存在枕骨支撑。颈椎轴向牵引负荷的分析表明，颈椎张力的唯一重要预测指标是牵引负荷的大小。颅骨中销钉位置的前后变化显着影响颈椎屈伸力矩和前后（AP）剪切力。数据显示，可通过向后偏置的销钉和头部后部的支撑来获得综合的颈椎张力，屈曲力矩和前向剪切力。牵引电缆角度的增加会增加颈椎屈曲力矩和前剪切力。施加颈椎牵引力时应仔细考虑以下变量，因为它们会显着影响颈椎负荷：悬吊牵引力的大小，前后销位置，枕枕的使用以及牵引力角度。