Gardner Wells tongs modification in pre-operative management for cervical facet dislocation: A case report.

Introduction: Cervical facet dislocations are one of the traumas that caused the neurological disability, and it is often found and shows a spectrum of facet fracture-dislocations. Cervical facet dislocation classified by the mean of mechanism into a flexion-distraction injury. The goal of the treatment is to reduce the dislocation in favour of the patient's condition and hospital facility.

Method: We reported a case of 32 years old female with incomplete spinal cord injury due to Flexion distraction injury of C4-C5 spine, cervical X-Ray shows anterior translation for about 50% of C4 relative to underlying C5 on lateral projection, the patient was diagnosed with bilateral facet cervical dislocation and treated by gradual closed reduction using Gardner Wells Tongs followed by posterior body stabilization and fusion.

Results: We initially load of 4 kg gradually along with continuous observation using lateral cervical radiograph and careful neurological assessment. The dislocation was finally reduced after gradual and dynamic loading with 14 kg load.

Discussion: There are several strategies for managing cervical injuries. Aside from whether the MRI has to perform before or after the reduction, the option on whether to use closed or open reduction can be managed at best in favour of the current condition.

Conclusion: Gardner Wells tongs is one of the best alternatives when the surgical approach is unavailable.