A treatise on orthopedic surgery . a crossbar at the upper extremity of the frame,and traction may be made by simply tightening them; or if theupper part of the frame is somewhat elevated, the weight of thepatients body makes the proper countertraction. This positionhas the advantage, also, of allowing the patient a better oppor-tunity to see what is going on about him (Fig. 33). In disease of the cervical region traction is usually of serviceand fixation of the head is always indicated in addition whenthe occipitoaxoid region is involved, either by sand-bags oneither side, or, preferably, by
A treatise on orthopedic surgery . a crossbar at the upper extremity of the frame,and traction may be made by simply tightening them; or if theupper part of the frame is somewhat elevated, the weight of thepatients body makes the proper countertraction. This positionhas the advantage, also, of allowing the patient a better oppor-tunity to see what is going on about him (Fig. 33). In disease of the cervical region traction is usually of serviceand fixation of the head is always indicated in addition whenthe occipitoaxoid region is involved, either by sand-bags oneither side, or, preferably, by some form of metal brace. 74 OBTHOPEDIC SUBGEBY. Greater fixation of the spine may be desirable in cases of moreacute disease. This may be attained bj the use of a light backbrace, or a plaster jacket, in connection with the frame. Suchsupport should not be applied, however, until the recession ofdeformity, which is to be expected under treatment by the hori-zontal fixation and overextension, has been obtained (Fig. 28). Fig. Potts disease of the middle dorsal region, a type of disease in wtiich horizontalfixation is always indicated. H. S., aged fourteen months. As this frame is simply a horizontal brace the child mayspend as much time in the open air as would be practicable wereany other appliance used. I have never seen other than favorable results from thismethod of treatment. Pain and discomfort are, as a rule, re-lieved almost immediately, and there is a corresponding im-provement in the general condition of the patient. Meanwhilethe growth of the trunk, which is so often checked by the diseaseand by the deformity, appears to progress normally, so that theapparatus may be actually outgrown before the termin^^-tion ofthis part of the treatment. Horizontal fixation is, of course, atreatment not complete in itself, since it must be supplemented TUBERCULOUS DISEASE OF THE SPINE. 75 bj the usual supports when the erect attitude is again duration varies from si
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