Unstable fractures of the thoracic and lumbar spine treated with Harrington distraction instrumentation and sublaminar wires.

Thirty unstable fractures of the thoracic and lumbar spine were treated surgically with Harrington distraction instrumentation supplemented with sublaminar wiring. The angulation was reduced from 26.8 degrees preoperatively to 4.9 degrees postoperatively, on average. The patients were mobilised and vigorously rehabilitated, starting 10 days after operation, without the support of orthoses or casts, and were followed up for a period of 9-30 months postoperatively. The angulation at the last follow-up averaged 5.4 degrees. Five neurologically intact patients remained intact, and 16 patients with total paraplegia remained unchanged. All 9 patients with incomplete neurological lesions improved on average through 1.7 grades (Frankel's grading). No neurological deterioration occurred in any patient.