Dislocation

summary dislocation

Dislocation is a displacement of one or more bones of a joint and may involve complete or partial separation of the contact surfaces (subluxation). The most common dislocations are: shoulder dislocation, patellar dislocation (on the knee), congenital hip dislocation, elbow dislocation, etc.

The causes of dislocations are traumas that affect the joints, displacing the bone from its proper place. Also, other factors can contribute like rheumatoid arthritis , genetic factors, Ehlers-Danlos disease, etc.

People more prone to falls, such as the elderly and children, and athletes who receive high impact on the joints are at risk for dislocation.

The initial symptoms are pain and the impossibility of carrying out the physiological movement of the displaced bone. With the rupture of soft tissue in the joint, inflammation develops at the site, which precedes a healing reaction at the site to recover the lost tissues. The diagnosis is usually made with the use of X-ray.

Ways to treat dislocations include the use of anti-inflammatories and surgical procedures to replace the bone in its proper place. It is also important to immobilize the affected part for healing and movement recovery. Physiotherapy is indicated in many cases to strengthen muscles and recover movement.

Medicinal plants normally used have anti-inflammatory action, such as arnica . Some procedures on how to prevent dislocations are: supervising patients prone to falls, proper practice of sudden movements and use of safety equipment in sports. Some tips on how to proceed in case of dislocation are: strictly follow your doctor’s tips for a quick recovery, do not try to put the bone back in place, do not move the patient, etc. Applications of cold and hot water packs help with recovery and pain relief.

Definition dislocation

What is dislocation? – Definition dislocation

Dislocation is a displacement of one or more bones of the joint, and can happen anywhere in the body. This displacement may be partial or complete, causing separation of the joint surfaces. When this displacement is partial and some part of each surface is still in contact, subluxation occurs.

Dislocation is also commonly known as “dislocation of a joint”. Many patients confuse dislocation with contusion, the latter being an injury to some part of the body, such as muscles, which does not cause fissures, or bone fractures or joint displacement. Bruising is usually accompanied by swelling (edema) and bruising . Sprains are also different from dislocations. Sprain is the term used for the injury that occurs when the normal limit of movement of a joint is exceeded, which may result in distension of ligaments and severe pain.

The most common dislocations are:

– shoulder dislocation

– Hip dislocation (including congenital hip dislocation)

– Patellar dislocation (knee dislocation)

– Hip dislocation (on the thigh bone, i.e. on the femur)

– Elbow dislocation

– Ankle dislocation

– Dislocation in the fingers

dislocation statistics

Although dislocation can happen anywhere in the human body, in some places displacement is more common, such as shoulders, fingers, elbows, wrists and knees. There are not many statistical and epidemiological data on the incidence of dislocation, however, some studies indicate that shoulder dislocation (also known as scapulohumeral dislocation) is the most common, with an incidence of 1.5 to 2% in the population and 7% in athletes. . In adults between 20 and 25 years old, the dislocation recurrence rate is 50 to 75%. In athletes, recurrence is greater than 90%.

Knee dislocation is a rare injury that, according to some authors, accounts for less than 0.02% of all orthopedic injuries. Men are more likely to suffer dislocations.

dislocation causes

Dislocation is not a communicable disease.

The main causes of dislocation (such as shoulder dislocation and hip dislocation) can be summarized below:

Dislocations caused by sports activities

One of the main causes of dislocation of the shoulder, hip, etc. are injuries caused by sports impacts. These impacts can be direct at the joint site (direct causes) or elsewhere (indirect causes), such as shoulder dislocation from elbow impact, knee dislocation from impact to the sole of the foot (such as when running). ATTENTION: any physical activity can cause dislocations if not practiced correctly and with supervision.

Dislocations caused by non-sporting impacts

Another major cause of dislocation is non-sporting impacts. This includes trauma that can occur in everyday life, such as a blow to the shoulder, a fall in the street or some other violent impact on a joint. Certain conditions, such as congenital malformations and muscle paralysis, favor the onset of dislocations, such as congenital hip dislocation. Fractures can also cause dislocation.

Subluxations can happen in patients with rheumatoid arthritis, since there is alteration of the surface of the joints and destruction of soft tissues.

In addition to direct or indirect trauma, dislocations can occur due to a violent movement or sudden traction, as occurs in dislocations in the shoulders and elbows of babies when they stumble and are holding an adult’s hand, which exerts a traction to hold the child’s arm. child and causes dislocation.

Other factors that cause dislocation of joints is the presence of diseases that destroy the elements of the joints, such as arthritis , tumors , paralysis, among others.

Dislocations caused by falls

Falls are an important condition for causing dislocations, especially in the elderly or people with weakened joints. Falling is particularly dangerous as it can dislocate several joints at once, such as the knee, ankle, elbow, shoulders, fingers, etc.

dislocation risk groups

The main risk groups for dislocations are:

– Athletes: are prone to impacts on the joints of various limbs. Many of these impacts are of high intensity and many dislocations can be recurrent.

– Elderly: the elderly are particularly more susceptible to falls and dislocations, due to a weakening of the elements that support the joints. With age, the joint elements wear out and the risk of dislocations increases.

– People with rheumatoid arthritis : these patients are at risk of developing dislocation due to wear on the joint surface and alteration of the soft tissues that constitute it.

– Babies and children: this type of patient is subject to dislocations because they have more fragile joints, they are also prone to have a higher incidence of dislocation.

– Patients with congenital disabilities. Some of these diseases alter the constitution of the joints, as in the case of congenital hip dislocation. Patients with Ehlers-Danlos Syndrome (or Cutis elastica) may also be at increased risk for dislocations.

To summarize, we can outline some main risk factors for dislocations:

dislocation symptoms

The initial symptom in complete dislocations and subluxations is the appearance of pain immediately after the trauma, which prevents movement of the injured joint. In the affected area, an inflammation develops, which causes the pain to increase. The deformity at the site of the dislocation can sometimes be very clear, due to the displacement of a bone, however, there are places where the dislocation cannot be distinguished from a fracture.

With the rupture of soft tissues, inflammation develops at the site with subsequent swelling (swelling). In addition, there is extravasation of blood, developing bruises. Days after the trauma and displacement, a healing reaction develops in the affected region. If the bones are in place, healing will fix them in place and restore normal position and movement. However, if the bone remains displaced, the fixation will be in an anomalous position, which may result in a deformity for the patient with functional limitation and movement of the joint.

A feature after dislocation is muscle weakness if the joint has been immobilized for a long time.

dislocation diagnosis

The diagnosis can be performed through X-ray exams, which are commonly requested to confirm the location of the displacement. In other cases of dislocation, such as congenital hip dislocation, some measures can be adopted. In this case, early diagnosis is of great importance to achieve good treatment results, therefore, in the newborn, two maneuvers can be performed as a diagnosis, which will only be valid after 2 months of life:

1. Ortolani maneuver: consists of a tactile sensation, a “click”, felt by the examiner when the thighs are abducted from knee and hip flexion. This sensation means the engagement of the head of the femur with the acetabulum.

2. b) Barlow maneuver: serves to determine whether there is hip instability, and consists of actively causing unilateral femoral dislocation, then the “click” occurs.

Ultrasound is also sensitive and efficient in diagnosing displacements.

In cases where the dislocation is associated with other diseases, such as tumors and arthritis, complementary exams, in addition to the patient’s clinical history, help in the diagnosis and location of the dislocated area. It is very important that the injured area is correctly diagnosed as a dislocation or a possible fracture.

dislocation complications

Some complications of dislocations are:

 – Injury to a nerve, such as the axillary nerve in shoulder dislocations and the sciatic nerve in hip injury;

 – Vascular complications, such as in elbow injuries, where there is a danger of injury to the brachial artery, resulting in ischemia which, if not restored, leads to irreparable damage;

– Rigidity, in the case of regions difficult to acquire the full range of motion, such as the elbow;

 – Osteoporosis , which can happen at a late stage if the dislocation damages joint surfaces;

 – Damage to internal organs and soft tissues, by displacement of a bone;

– Susceptibility and reappearance of new dislocations. This occurs when the supporting elements of the joint are not properly repaired, which can lead to instability.

In addition, many dislocations may be associated with fractures, which hinder the patient’s recovery.

dislocation treatment

To treat dislocation, usually the first step in treatment is to replace the dislocated bone in its proper place. This must be done by a specialized doctor who will adopt the necessary measure to reduce the dislocated area. This process can be very painful for the patient, therefore, it is done under the use of anesthetics and non-steroidal anti-inflammatory drugs such as ibuprofen , paracetamol , naproxen, diclofenac , etc. When manual reduction of the dislocation is not possible, a surgical procedure can be used to replace the displaced parts.

Right after this part, the dislocated region must be immobilized for adequate healing of the joint elements and, thus, recovery of joint movement. This is usually done with splints, plaster or any other materials that reduce movement in the region. The immobilization time varies according to the degree of injury and affected region and must be evaluated by a doctor. Some dislocations, such as hip dislocations, require many months to heal.

Once the ligaments of the joint have recovered, physiotherapy is commonly recommended for complete recovery of movement. Physiotherapeutic treatment depends on the degree of dislocation and the injured part.

Dislocations accompanied by soft tissue destruction or recurrent require surgical intervention.

Below is a summary of how to treat and proceed in case of dislocation:

herbal medicine dislocation

Some anti-inflammatory plants may be indicated to reduce the pain felt by the patient after a dislocation. Examples of these herbs are:

– Janaúba bark (Himatanthus drasticus (Mart.) Plumel);

– Infusions of arnica leaves and compresses ( Arnica montana L.). ATTENTION: contraindicated in pregnancy and lactation;

– Application, with gauze, of the latex extracted from the branches and leaves of Jatropha curcas (Jatropha curcas L.);

– Ingestion of mangaba tea or northern mangabeira (Hancornia speciosa Gomez).

There are currently a variety of arnica-based massage gels on the market. It is important that the doctor prescribes any herbal medicine and assesses the contraindications in each case.

dislocation homeopathy

Some homeopathic medicines are indicated to decrease inflammation. Some examples are:

– Arnica montana 6CH;

 – Ruta graveolens 6CH;

 – Rhus toxicodendron 6CH.

It is important that the homeopathic physician indicates the appropriate treatment for each patient according to their characteristics.

dislocation tips

Here are some important tips on how to proceed in cases of dislocation:

– Do not try to put the joint back in place, this must be done by a trained health professional.

– Immobilize the injured area carefully and take the patient to the emergency room immediately.

– Do not move the patient from the site without immobilizing the injured region.

– During recovery, carefully follow the rest period for complete healing of the ligaments.

– In the case of physiotherapy, follow the treatment correctly, for movement rehabilitation.

– It is indicated that the patient does not eat anything until he is attended by a doctor, as he may need to apply anesthesia.

– Use ice packs to relieve pain and inflammation at the injured site. Apply to the area for about 15 to 20 minutes during the first few days of the injury. When the pain and inflammation have subsided, use hot water packs to relax the tight and inflamed muscles. Limit the application of hot compresses to 20 minutes.

– After 1 or 2 days of the injury, make light movements with the joint to recover the movements. Follow the advice of your doctor and physiotherapist. Inactivity has a worse effect on recovery.

dislocation prevention

Here are some measures on how to prevent dislocations:

– Provide a safe and suitable environment for children and the elderly, preventing falls;

– Supervise patients prone to falls, such as children and the elderly;

– Use proper techniques when performing a sport or physical activity: many dislocations occur due to poor practice of movements in a sport;

– Use appropriate equipment in sports. ATTENTION: if you are a beginner, always have guidance from an instructor;

– If you have suffered a dislocation, strictly follow all your doctor’s instructions to recover properly. Remember that poorly healed dislocated joints tend to dislocate more.

Jeanne Kenney
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I’m a stylist trainer, a content creator, and an entrepreneur passion. Virgo sign and Pisces ascendant, I move easily between my dreams, the crazy world I want, and my feet on the ground to carry out my projects.

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