Biomechanical Implications of Asymmetric Gardner-Wells Tong Placement During Cervical Spine Traction

In cases of cervical facet dislocations, traction is typically delivered in the acute se! ing with tongs a! ached to the skull via two pins. Although the pins are recommended to be inserted symmetrically in a neutral loading position, erroneous asymmetric pin placement has been documented in case reports, but its biomechanical implications are unknown. The current study utilized a human surrogate to evaluate the infl uence of asymmetrically placed pins in the axial or frontal planes. In addition, asymmetry of the cable that delivers the traction force to the tongs was also investigated. In the majority of the pin confi guration experiments, pin asymmetry did not signifi cantly aff ect cervical spine loading. One exception was if one pin was placed 1 cm anterior to neutral and the contralateral was in the neutral position. This confi guration resulted in a signifi cant increase in the cervical extension moment, which should typically be avoided because it can hinder reduction. (Journal of Surgical Orthopaedic Advances 33(4):233-239, 2024)

Key words: Gardner-Wells tongs, cervical facet dislocation, cervical traction, asymmetric pin placement