Dislocation

A dislocation is an injury to a joint, a place where two or more bones come together, that leads to abnormal alignment of the bones making up the joint.

Dislocations are usually accompanied by intense pain and deformity and immobilization of joints.

Dislocations mostly occur in the shoulder and fingers although other sites, such as the elbow, knees and hips can be also affected.

Immediate medical treatment is required for dislocations.

Most dislocation joints return to full function after a few weeks if proper treatment is provided. Some dislocations especially of the shoulder may increase the risk of future dislocations.

Signs and symptoms of dislocation include:

• A visibly deformed shoulder
• Swelling and bruising  
• Intense pain    
• Immobility of the joint  
• Numbness, tingling or weakness in the area around the shoulder,such as the neck and upper arm  
• Spasm of the muscles in the affected area

Dislocations can be caused by:

• trauma that can occur during sport injuries,
• trauma not related to sports, such as motor vihecle accidents,
• falls, especially when a person lands on an outstretched arm.

A physical exam can be used to diagnose a dislocation.

Other tests include X-ray to confirm the dislocation and check for broken bones or other damages to the joint and MRI to assess the damage to the soft tissue structures situated around the affected joint.

Treatment for dislocation depends on the affected joint and severity of the injury.

Treaments may include:

• Closed reduction - a procedure in which the bones shoulder joint are placed back into place. Patients may be given a muscle relaxant, sedative or general anaesthesia depending on the intensity of pain and swelling. Placing the shoulder joint back in place helps to reduce pain.

• Surgery in cases where a patient has a weak joint, ligaments or tendons or when there is damge of vessels or nerves near the ainjured joint.

• Immobilization of the joint with a splint or sling for a few days to a few weeks depending on the extent of injury, to prevent the movement of the affected joint.

• Pain killers of muscle relaxants to help the patient deal with pain or muscle spasms.

• Rehabilitation after the injured joint has healed to restore shoulder motion, strength and stability.                                                                  

Dislocations can be prevented by:

• avoiding falls,
• wearing protective gear during contact sports,
• regular exercise to maintain strength and flexibility in the joints and muscles.

Patients with a history of shoulder dislocations can avoid future dislocations by following specific strength and stability exercises for the shoulder joint.

There are different ways to adapt your lifestyle in coping with dislocation.

The following can help to reduce discomfort and encourage healing of a dislocated joint:

• Resting the joint and avoiding tasks that can cause more damage to the injured joint.

• Applying ice then heat to the joint  to reduce inflammation and pain. Ice can be used within the first two days while heat can be applied after two-three days to relax tight and sore muscles. Heat should not be applied for more than 20 minutes at a time.

• Taking over-the-counter pain meication such as ibuprofen (Advil, Motrin IB) and acetaminophen (Tylenol).

• Maintaining the range of motion in the joint through some gentle exercises.                                                                                             

There are several risks and complications associated with dislocation.

Factors that increase the risks of dislocations include:

• Susceptibility to falls  
• Being born with weak ligaments
• Participating in high-impact or contact sports, such as gymnastics, wrestling, basketball and football.  
• Motor vihecle accidents  

 Complications of dislocations include:

• Tearing of muscles, tendons and ligaments that keep the joint in place
• Damge to the nerves or blood vessels around the affected joint
• Instabiliity of the joint  which increases the risk of future dislocations
• An increased risk of developing arthritis in future