Dislocations And Subluxations

Commonly causing extreme pain, dislocations are displacements of joint bones so that their articulating surfaces totally lose contact; subluxations are partial displacements of the articulating surfaces. Dislocations and subluxations occur at the joints of the shoulders, elbows, wrists, digits, hips, knees, ankles, and feet.

These injuries may accompany fractures of these joints or result in deposition of fracture fragments between joint surfaces. Even without a concomitant fracture, a displaced bone may damage surrounding muscles, ligaments, nerves, and blood vessels, especially if reduction is delayed.

Causes

A dislocation or subluxation may be caused by a congenital problem (such as congenital dislocation of the hip), or it may follow trauma or disease of surrounding joint tissues (for example, Paget's disease of the bone).

Diagnostic tests

A thorough medical history and physical exam by a physician is the first step in the correct diagnosis of dislocations and subluxations. X rays of the joint and adjacent bones can locate and help determine the extent of dislocated joints

Treatment

Immediate reduction and immobilization can prevent additional tissue damage and vascular impairment. Closed reduction consists of manual traction under general anesthesia or local anesthesia and sedatives.

During reduction, morphine I.V. controls pain; midazolam I.V. controls muscle spasm and facilitates muscle stretching during traction. Some injuries require open reduction under regional block or general anesthesia. Such surgery may include wire fixation of the joint, skeletal traction, and ligament repair.

After reduction, a splint, a cast, traction, or another device immobilizes the joint. In most cases, immobilizing the digits for 2 weeks, hips for 6 to 8 weeks, and other dislocated joints for 3 to 6 weeks allows surrounding ligaments to heal.

Prevention

When an individual is involved in strenuous sports or heavy work, involved joints may be protected by elastic bandage wraps, tape wraps, knee and shoulder pads, or special support stockings. Keeping the muscles surrounding the joint strong will also help prevent dislocations. Long-term problems may also be prevented by allowing an adequate amount of time for an injured joint to rest and heal prior to resuming full activity.

© Doctor-clinic.org. All rights reserved.

Disclaimer :- The materials in this web site are in no way intended to replace the professional medical care, advice, diagnosis or treatment of a doctor. The web site does not have answers to all problems. Answers to specific problems may not apply to everyone. If you notice medical symptoms or feel ill, you should consult your doctor . We will not be liable for any complications or other medical accidents arising from or in connection with the use of or reliance upon any information in this web site.