Dislocations and Subluxations
What is it?
A dislocation is a complete loss of contact between the bone surfaces in a joint that normally meet; a subluxation is a partial loss of contact. Within a normal joint, ligaments hold the bones together so that their surf aces are in close contact, and the entire joint is encased in a membrane ( joint capsule). When the bones become dislocated or subluxated (usually because of a violent physical trauma), damage to the ligaments and joint capsule occurs, resulting in severe pain and loss of mobility. Commonly affected joints include those of the shoulders, fingers, knees, hips, ankles, and feet.
Dislocations and subluxations usually respond well to treatment, and normal joint movement is usually restored within two months of the injury. However, in some cases the ligaments may remain slightly stretched after healing and recurrent subluxation or dislocation may occur. In more severe cases a dislocation may involve nerve damage and result in some degree of paralysis.
What Causes It?
- Injury is the most common cause of dislocations.
- Certain joints, such as the hip, are congenitally prone to dislocations in some people.
- Previous injuries of a joint may so weaken surrounding tissues that subsequent subluxation or dislocation may occur with little provocation.
Prevention
- Because most are due to injury, dislocations and subluxations cannot be prevented.
Diagnosis
- Physical examination and patient history.
- X-rays rule out or confirm the condition.
How to Treat It
- Get immediate professional medical care; prompt treatment can prevent additional tissue, nerve, and blood vessel damage. Do not try to reposition the joint yourself . On the contrary, the joint should be immobilized with a splint or sling if possible.
- Apply ice to the affected area to reduce swelling while awaiting professional care.
- Do not eat or drink (a full stomach interferes with the anesthesia that may be necessary during the repositioning of the joint).
- A doctor or other medical personnel will reposition the joint. Local or general anesthesia may be used to reduce pain during the procedure.
- Surgery may be required to reposition the joint in more severe dislocations. Wire may be used to keep the bones in place.
- A splint, cast, or traction may be required to immobilize the joint after repositioning, to allow damaged ligaments to heal.
- A program of physical therapy may be prescribed to build strength and mobility after the affected joint has healed.
When to Call a Doctor
- Call a doctor immediately if you think you have dislocated a joint, because it becomes increasingly difficult to reposition the joint properly as the surrounding tissues swell.
- EMERGENCY Call an ambulance or get to a doctor immediately if you experience paralysis, lack of a pulse, or extreme pain near a dislocated joint. This may indicate that the blood supply to the area has been blocked by the injury.
For more Johns Hopkins health information, please visit Johns Hopkins Health Alerts.
For medical appointments at Johns Hopkins, please call 866-386-1617.
All information contained within the Johns Hopkins Symptoms and Remedies website is intended for educational purposes only. Consumers should never disregard medical advice or delay in seeking it because of something they may have read on this website.
Copyright © 2008 Medletter Associates, LLC
Content excerpted from Johns Hopkins Symptoms and Remedies: The Complete Home Medical Reference.