What Is a Joint Dislocation?

Dislocation of the joint is also called dislocation, which means that the upper and lower bone ends constituting the joint have lost their normal positions and have been dislocated. Due to multiple violent effects, dislocations are most likely to occur in the shoulder, elbow, jaw, and finger joints. The symptoms of joint dislocation include severe pain at the joint, loss of normal joint activity, and deformity of the joint. Clinically, it can be divided into several cases such as traumatic dislocation, congenital dislocation and pathological dislocation. After the dislocation of the joint, the soft tissues such as the joint capsule, ligaments, articular cartilage, and muscles are also damaged. In addition, swelling around the joints may cause hematomas. If the hematomas are not reset in time, the hematomas will be mechanized and the joints will lose their function.

Basic Information

Also known as

dislocation

English name

dislocation

Visiting department

orthopedics

Common locations

Shoulder, finger joints

Common causes

Violent effect

Common symptoms

Joint dislocation, pain, difficulty moving, inability to move

Clinical manifestations of joint dislocation

Joint dislocation has the symptoms of general injury and the special manifestation of dislocation. After injury, joint dislocation, pain, difficulty or inability to move. Dislocations usually affect active joints such as the ankle, knee, hip, wrist, and elbow, but the shoulder and finger joints are the most common. Inactive joints, such as those in the pelvis, can also be separated when the ligaments that hold them together are pulled or torn. Vertebral dislocation can be life-threatening if it damages the nerves or spinal cord. Significant intervertebral dislocations, damage to the spinal cord, and paralysis.

General symptoms

(1) The pain is obvious.

(2) The joints are swollen.

(3) The joint loses its normal mobility and dysfunction.

2. Special performance

(1) Malformation After joint dislocation, deformities such as rotation, adduction or abduction, and lengthening or shortening appear in the limbs, which are asymmetric with the healthy side.

(2) Elastic fixation After the dislocation of the joint, the unteared muscles and ligaments can keep the dislocated limb in a special position, and there is a sense of resistance and elasticity during passive movement.

(3) The joint socket is empty.

Joint dislocation examination

X-ray examination of the front and side of the joint can determine whether there is dislocation, the type of dislocation, and whether there is a combined fracture to prevent missed diagnosis and misdiagnosis.

Joint Dislocation Diagnosis

1. Have a significant history of trauma.

2. The clinical manifestations are joint pain and swelling, deformity, elastic fixation and joint socket empty.

3. X-ray examination can determine the location, degree, direction of dislocation and whether there is fracture and displacement.

Joint Dislocation Treatment

Treatment principle

Manipulative reduction as soon as possible under anesthesia after injury: proper fixation to facilitate soft tissue repair; timely activities to restore joint function.

2. Treatment steps

(1) Reset Mainly use manual reset.

(2) Fixation After reduction, fix the joints in a stable position for a period of 2 to 3 weeks.

(3) Functional exercise During the period of fixation, the muscles around the joints should be frequently contracted and the other joints of the affected limb should be actively moved to promote blood circulation and eliminate swelling; avoid muscle atrophy and joint stiffness.

3. Therapy

Once joint dislocation occurs, the injured joint of the patient should be quietly fixed in the most comfortable position of the patient. Seek medical attention as soon as possible after proper fixation. Note that when undressing a patient, take off the normal side first, then the injured side, and vice versa when wearing clothes.

(1) Shoulder joint dislocation Generally, it needs to be reset after anesthesia or muscle relaxation. Common methods of reduction include: The injured person is supine, the surgeon stands on the injured side, and the heel is placed near the affected limb In the armpit of the affected limb, make a fulcrum between the chest wall and the humeral head, hold the forearm and wrist of the affected limb and pull along its longitudinal axis. After reaching a certain traction force, gently shake or rotate its upper limbs internally and externally and gradually move closer to the trunk to reset. Lifting and lifting method In the sitting position, the assistant pulls the wrist of the affected limb downwards according to the position of the affected limb, and holds the upper chest with a fixing band or another assistant. After traction, the surgeon resets the humeral head with the middle finger of both hands or with the index finger in the axillary position. After the X-ray film examination was completed, the shoulder was fixed with adhesive tape or bandage for 3 weeks. For habitual dislocation, repair can be used.

(2) Dislocation of elbow joint In supine position, the assistant fixes the upper arm of the affected limb to resist traction, and the surgeon holds his forearm and pulls in the direction of the upper limb axis distally. After reduction, the upper limb cast was fixed at the functional position for 3 weeks.

(3) Subluxation of the radius head The surgeon holds the elbow of the affected limb in one hand, the thumb touches the small head of the radius, and the other hand gently grips the wrist for gentle traction and pronation of the forearm. That is, the radial head feels a crisp sound or bounces and resets. The forearm was suspended with a bandage to properly protect the affected limb for 1 week.

(4) Hip dislocation If there is shock, take a supine position to keep the airway open, pay attention to warmth and rush to the hospital for rescue. Emergency rush to hospital for manual reduction under anesthesia. After reduction, it can be fixed with skin traction or hip herringbone plaster for 6-8 weeks. After lifting the external fixation, continue to exercise hip muscle strength, and gradually increase the range of hip joint movement.

(5) The treatment of open joint dislocation strives to perform debridement within 6 to 8 hours. After thorough debridement, the dislocation is restored, the joint capsule is sutured, the soft tissue is repaired, the skin is sutured, and the rubber band is drained for 48 hours. Gypsum was fixed at the functional position for 3 to 4 weeks, and appropriate antibiotics were selected to prevent infection.