Dislocations

A dislocation is usually the result of a fall or a blow, or sometimes from playing a contact sport, such as basketball, hockey, and football. 

There are several risk factors associated with a joint dislocation including susceptibility to falls, heredity, sports participation, and motor vehicle accidents.

In motor vehicle accidents, hip dislocations are very common for people who don’t wear seatbelts.

The most common symptoms associated with a dislocated joint include:

• Swelling or Discoloration
• Intense Pain
• Visible deformity or out of place joint
• Immobility

You can dislocate your finger and toe joints as well as your ankles, elbows, hips, jaw, knees, shoulders, and wrist. The most commonly dislocated joint is the shoulder.

Dislocations are very common sports injuries.

You should treat a dislocation as an emergency and seek prompt medical attention to return your bones to their proper positions.

While you wait to see a doctor, you should ice the joint and keep it immobile. You can also take ibuprofen for the pain. You will have pain until the dislocation is put back into place. Only trained medical professionals should do this. Do not attempt to move or jam a dislocated bone back in place yourself as you can damage blood vessels, muscles, ligaments, and nerves.

Your doctor may order a bone X-ray (radiography) to confirm the dislocation or any other damage to your joint. An MRI may also be ordered to help your doctor assess damage to the soft tissue structures around a dislocated joint.

A dislocation can be partial or complete. A complete dislocation means the joints have fully separated. A partial dislocation means part of the joint is still in place. 

A simple dislocation doesn’t cause bone injury, a complex dislocation can include serious bone and ligament injury, and a severe dislocation can also impact the nerve and blood vessels. 

Treatment usually depends on which joint you dislocate and the severity of the injury, however, treatment options usually include: 

Reduction. Your doctor may try gentle maneuvers to help your bones back into position. Sometimes a local or general anesthetic is administered to help with the pain before manipulation of your bones. 

Immobilization. After your bones are back in position, your doctor might immobilize your joint with a splint or sling. Depending on the extent of damage to nerves, blood vessels, and supporting tissue, you may have to wear the splint or sling for several weeks.

Surgery. Your doctor may recommend surgery if your dislocated bones cannot be moved into their correct positions or if the nearby blood vessels, nerves, or ligaments have been damaged. Surgery may also be recommended for patients who have a history of recurring dislocations.

Rehabilitation. Once your splint or sling is removed, your doctor will have you begin a rehabilitation program designed to help restore your joint’s range of motion and strength.

When treated properly, you can return to normal activity after several weeks of rest and rehabilitation. Note that some joints, such as the elbow, knee, and shoulder, may have an increased risk of repeat dislocation.

After being treated for a dislocation injury, you can do several things to help ease discomfort and encourage healing:

• Rest your dislocated joint.
• Apply ice and heat to help reduce inflammation and swelling. For the first day or two, use a cold pack for 15 to 20 minutes at a time. After 2 or 3 days, use hot packs or a heating pad for 15 to 20 minutes at a time to help relax tightened and sore muscles.
• Take a pain reliever, such as ibuprofen, naproxen or acetaminophen.
• Maintain the range of motion in your joint doing gentle exercises as prescribed by your doctor or physical therapist to avoid stiff joints.

A joint dislocation can cause several complications including:

• Muscle, ligament, and tendon tears that support the injured joint
• Nerve or blood vessel damage in or around the joint
• Risk of Reinjury
• Arthritis in the affected joint as you age

Surgery may be required for torn muscles, ligaments, and tendons that support the injury joint, or for nerve or blood vessel damage in or around the joint.

There are several things you can do to prevent a dislocation including:

Ensure your home is well-lighted. Having a well-lighted home can help prevent falls in your home. You should also remove any potential tripping hazards from the areas where you walk.

Do Strength and Stability Exercises. Doing strength and stability exercises will help you improve joint support and avoid recurrent dislocations. Once you’ve dislocated a joint, you may be more susceptible to future dislocations.  

Wear Protective Gear. If you play contact sports, you should wear the suggested protective gear.

Here are the DOs and DON’Ts for handling an emergency situation:

DOs:

• Call for medical assistance immediately if the victim has a dislocation, broken bone, or severe bleeding.
• Keep the victim still and provide reassurance.
• Cover the victim with a coat or blanket.

DON’Ts:

• Do not try to move a dislocated joint back into place. Only trained medical professionals should do this.
• Do not test a misshapen bone or joint for loss of function.
• Do not give the victim anything by mouth.
• Do not move the victim if you suspect a head, back, or neck injury.
• Do not move the victim with an injured hip, pelvis, or upper leg unless it is absolutely necessary. If you must move the victim immediately, drag him or her by the clothing.
• Do not move the victim unless the injured area is completely immobilized.