Sometimes a dislocation damages the cartilage at the ends of bones in the joint called joint surfaces. Normally, this smooth, tough, protective tissue enables joints to move smoothly. Damaged cartilage tends to scar, causing osteoarthritis Osteoarthritis OA Osteoarthritis is a chronic disorder that causes damage to the cartilage and surrounding tissues and is characterized by pain, stiffness, and loss of function.
Arthritis due to damage of joint The knee, elbow, and shoulder are particularly likely to become stiff after they are dislocated, especially in older people. Also, the injury that causes the dislocation may weaken or tear the tissues that stabilize the joint, such as ligaments and tendons. Physical therapy is usually needed to prevent stiffness and help the joint move as normally as possible. Surgery is often needed to repair the damaged cartilage. After such surgery, the cartilage is less likely to scar, and if scarring occurs, it tends to be less severe.
Surgery is sometimes needed to repair torn ligaments or tendons. If a dislocation occurs suddenly, people must decide whether to go to an emergency department, call their doctor, or wait and see whether the problem pain, swelling, or other symptoms goes away or lessens on its own.
People should be taken to an emergency department, often by ambulance, if any of the following apply:. The problem is obviously serious for example, if it resulted from a car crash or if people cannot use the affected body part.
They have symptoms of a complication—for example, if they lose sensation in the affected body part, they cannot move the affected part normally, the skin feels cool or turns blue, or the affected part is weak.
The injury causes pain or swelling, but they do not think the injured part is fractured or severely injured. If none of the above apply and the injury seems minor, people can call the doctor or wait and see whether the problem goes away on its own. To check for severe injuries and complications, such as a disrupted blood flow, significant blood loss, an open wound, nerve damage, and compartment syndrome Compartment Syndrome Compartment syndrome is increased pressure in the space around certain muscles.
If any of these injuries and complications are present, doctors treat them as needed, then continue with the physical examination Physical examination A dislocation is complete separation of the bones that form a joint.
Often, a dislocated joint remains dislocated until it is Doctors ask the person or a witness to describe what happened. Often, the person does not remember how an injury occurred or cannot describe it accurately. Knowing how the injury occurred can help doctors determine the type of injury.
Also, doctors ask in which direction the joint was stressed during the injury. Doctors also ask when the pain started. If it started immediately after the injury, the cause may be a dislocation, fracture, or a severe sprain. If the pain began hours to days later, the injury is usually minor. If the pain is more severe than expected for the injury or if the pain steadily worsens during the first hours after the injury, compartment syndrome may have developed or blood flow may be disrupted.
Checking for open wounds, joints that look misshapen, swelling, bruising, and impaired movement of the joint. To check for signs of blood vessel damage and disrupted blood flow, doctors check pulses and skin color and temperature. When blood flow is disrupted as can occur in compartment syndrome , pulses eventually disappear or become weak and the skin becomes pale and cool.
Doctors measure blood pressure, which is low in people who have lost a lot of blood. To check for nerve damage, doctors test whether the person can move muscles normally. If the person cannot move the affected muscles, the nerves that control those muscles called motor nerves may have been damaged. Doctors also evaluate sensation in the skin—whether the person can feel normally—and ask whether the person has abnormal sensations, such as a pins-and-needles sensation, tingling, or numbness.
If sensations are abnormal or decreased, the nerves that are responsible for skin sensation called sensory nerves may have been damaged. Doctors gently feel the injured part to determine whether bones are out of place and whether the area is tender. Doctors also check for swelling and bruising. They ask whether the person can use, put weight on, and move the injured part. Doctors test the stability of a joint by gently moving it, but if a fracture or dislocation is possible, x-rays are done first to determine whether moving the joint is safe.
Doctors check for grating or crackling sounds crepitus when the injured part is moved. These sounds may indicate a fracture. Moving the affected joint can also help doctors determine the severity of an injury. Stress testing may be done to evaluate the stability of an injured joint. However, if a fracture or dislocation is suspected, stress testing is postponed until x-rays are done to check for these injuries. To stress a joint, doctors gently move the joint in a direction that is usually perpendicular to the joint's normal range of motion.
If the joint feels very unstable, doctors suspect a dislocation or a severe ligament injury. Or doctors immobilize the injured joint until the spasm goes away usually after a few days and then examine the joint. X-rays X-rays A doctor can often diagnose a musculoskeletal disorder based on the history and the results of a physical examination. Laboratory tests, imaging tests, or other diagnostic procedures are sometimes Magnetic resonance imaging MRI Computed tomography CT and magnetic resonance imaging MRI A doctor can often diagnose a musculoskeletal disorder based on the history and the results of a physical examination.
Computed tomography CT Computed tomography CT and magnetic resonance imaging MRI A doctor can often diagnose a musculoskeletal disorder based on the history and the results of a physical examination. X-rays are useful for diagnosing dislocations, as well as fractures. X-rays are not useful for detecting injuries to ligaments, tendons, or muscles because they show only bones and the fluid that collects around an injured joint. CT or MRI may be done to check for subtle fractures, which may accompany a dislocation.
Angiography Angiography In angiography, x-rays are used to produce detailed images of blood vessels. It is sometimes called conventional angiography to distinguish it from computed tomography CT angiography and magnetic Electroencephalography EEG is a simple, painless procedure in which Serious complications of dislocations require immediate treatment. Without treatment, complications may get worse, becoming more painful and making loss of function more likely. Also, some complications, such as compartment syndrome Compartment Syndrome Compartment syndrome is increased pressure in the space around certain muscles.
Without treatment, these complications can cause serious problems or even death. If people think that they have a fracture or another severe injury, they should go to an emergency department. If they cannot walk or have several injuries, they should go by ambulance.
Until they can get medical help, they should do the following:. Prevent the injured limb from moving immobilize it and support it with a makeshift splint, sling, or a pillow. If arteries are damaged, doctors surgically repair them unless the arteries are small and blood flow is not affected.
The goal is to make sure the injured part is not deprived of blood. Compartment syndrome Compartment Syndrome Compartment syndrome is increased pressure in the space around certain muscles. Severed nerves are also repaired surgically, but this surgery can be delayed until several days after the injury if necessary.
If nerves are bruised or damaged, they may heal on their own. If the skin is torn, the wound is covered with a sterile dressing, and the injured person is given a vaccine to prevent tetanus Diphtheria-Tetanus-Pertussis Vaccine The diphtheria, tetanus, and pertussis vaccine is a combination vaccine that protects against these three diseases: Diphtheria usually causes inflammation of the throat and mucous membranes Also, the wound is cleaned, usually after a local anesthetic is used to numb the area.
Most moderate and severe dislocations, particularly very unstable ones, are immobilized immediately with a splint. This measure helps decrease pain and prevent further injury to soft tissues by unstable dislocations. Pain is treated, typically with opioid pain relievers Opioid Analgesics In some cases, treating the underlying disorder eliminates or minimizes the pain. For example, setting a broken bone in a cast or giving antibiotics for an infected joint helps reduce pain PRICE refers to the combination of protection, rest, ice, compression pressure , and elevation.
Protection helps prevent further injury that could worsen the original one. Typically, a splint or other device is applied. Rest prevents further injury and may speed healing. For example, they may need to use crutches or to not participate in contact sports. Ice and compression minimize swelling and pain. Ice is enclosed in a plastic bag, towel, or cloth and applied for 15 to 20 minutes at a time, as often as possible during the first 24 to 48 hours.
Usually, compression is applied to the injury with an elastic bandage or a splint. Elevating the injured limb helps drain fluid away from the injury and thus reduce swelling. The injured limb is elevated above heart level for the first 2 days. After 48 hours, people can periodically apply heat for example, with a heating pad for 15 to 20 minutes at a time. Heat may relieve pain. However, whether heat or ice is best is unclear, and what works best may vary from one person to another.
After reduction is done, doctors usually take x-rays to determine whether the injured parts are in their normal position. Some dislocations must be realigned surgically called open reduction Surgery A dislocation is complete separation of the bones that form a joint.
The types of drugs that are used depend on how severe the injury is and how reduction is to be done:. Closed reduction of minor dislocations such as those of the fingers or toes : A local anesthetic, such as lidocaine , injected near the injured part, may be all that is needed. Closed reduction of major dislocations such as those of the arm, shoulder, or lower leg : People may be given a sedative and pain relievers by vein. The sedative makes them drowsy but not unconscious.
They may also be given a local anesthetic by injection. For example, if people have a shoulder dislocation, lidocaine may be injected into the shoulder joint. Open reduction: People are given a general anesthetic by injection or through a face mask, making them unconscious. This procedure is done in an operating room. Casts, splints, or slings are usually used after closed reduction of a dislocation.
Some dislocated joints require only a sling or splint, which is applied after the joint is returned to its normal position. Immobilization reduces pain and helps with healing by preventing further injury to surrounding tissues. Immobilization is helpful for most moderate or severe dislocations. Joints on both sides of the injury are immobilized. If immobilization lasts too long for example, for more than a few weeks in young adults , the joint may become stiff, sometimes permanently, and muscles may shorten causing contractures or shrink waste away, or atrophy.
Blood clots may develop. Such problems can develop quickly, and contractures can become permanent, usually in older people.
Consequently, doctors encourage movement as soon as possible. To apply a cast, doctors wrap the injured part in cloth, then apply a layer of soft cottony material to protect the skin from pressure and rubbing.
Over this padding, doctors wrap dampened plaster-filled cotton bandages or fiberglass strips, which harden when they dry. The team of orthopedic doctors at AICA Orthopedics can help develop an individualized treatment plan for you so you can get back to your regular range of motion while pain-free! Call us now. How to Distinguish Between a Dislocation and a Sprain. What Is a Sprain? How to Diagnose a Sprain In the case of a moderate to severe sprain, your doctor will likely want to rule out a broken bone with advanced diagnostic imaging.
Treating Sprains When you experience a mild sprain, you may experience slight discomfort and mild pain and attempt to treat the affected area at home.
What Is a Dislocation? How to Diagnose a Dislocation When a joint is dislocated to the point that you cannot move the affected bone, you might wonder why your doctor would need to use diagnostic testing to confirm because it feels so obvious! Treating Dislocations When you have a joint dislocation, you will want an orthopedic doctor to move the joint back into place, which is called a reduction.
Category: Shoulder Pain. Search for:. This field is for validation purposes and should be left unchanged. Knowing the differences between sprains, strains, fractures breaks , and dislocations will help ensure you are well looked after. A sprain is a sudden injury that occurs to the ligaments within a joint as a result of a wrenching or twisting motion.
Simply put, it affects our joints and not our muscles unlike a strain. In most cases, the patient will have bruising, swelling, and tenderness in the area, and are unlikely to be able to move it without pain or bear weight on it. In severe sprains, the patient may also experience altered sensations beyond the site of injury and have limited to no movement at all.
In most cases, the sprained joint can heal within 2 to 8 weeks, although more severe sprains may take up to 8 months. Unlike sprains, strains are injuries that affect the tendons or muscles of the body, and are most often caused by over-reaching, excessive weightlifting, twisting, jarring, or repetitive movements.
They can occur suddenly or over a long period of time. Symptoms of strains include tenderness, bruising, swelling, muscle spasms or cramps, restricted movement throughout the area, and weakness. Recovery for strains can be anywhere from a few weeks to several months, and in extreme cases may require surgical consult or physical therapy. Fractures more commonly known as breaks are injuries to the bone that cause it to crack.
Although there are many types of fractures, the recognition and treatment of them is consistent. The affected area will often be bruised, swollen, tender, and may have obvious deformity.
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