Dislocation

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updated December 30, 2008

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Dislocation

Filed under: Boomer's Health
A joint is a location where two or more of your bones come together. A dislocation is an injury to your joint in which the ends of your bones are forced from their normal positions. This injury temporarily deforms and immobilizes your joint and may result in sudden and severe pain.

Dislocations may occur in your major joints — shoulder, hip, knee, elbow and ankle — or in the smaller joints in your fingers, thumbs and toes.

If you suspect a dislocation, seek prompt medical attention to return your bones to their proper positions without damaging your joint. When treated properly, most dislocations return to normal function after several weeks of rest and rehabilitation. However, some joints, such as your shoulder, have an increased risk of repeat dislocation.

Symptoms

A dislocated joint may be:

Visibly deformed or out of place
Swollen or discolored
Intensely painful
Immovable

You may also experience tingling or numbness near the injury — such as in your foot for a dislocated knee or in your hand for a dislocated elbow.

When to see a doctor
It can be difficult to tell a broken bone from a dislocated bone. If you or your child appears to have either type of injury, get medical help right away.

While you're waiting for medical attention:

Don't move the joint. Splint or sling the affected joint in its current position. Don't try to move a dislocated joint or force it back into place. This can damage the joint and its surrounding muscles, ligaments, nerves or blood vessels.
Ice the injured joint. Applying ice to the injured joint can help reduce pain and swelling by controlling internal bleeding and the buildup of fluids in and around the injured joint.

Causes

Causes of dislocations include:

Sports injuries. Dislocations can occur in contact sports, such as football and hockey, and in sports that may involve falls, such as downhill skiing, gymnastics and volleyball. Basketball players and football players also commonly dislocate joints in their fingers and hands by accidentally striking the ball, the ground or another player.
Trauma not related to sports. A hard blow to a joint during a motor vehicle accident is a common cause of dislocation.
Falls. You may dislocate a joint during a fall.

Tests and diagnosis

Besides physically examining your injury, your doctor may order the following:

X-ray. An X-ray of your joint is used to confirm the dislocation and may reveal broken bones or other damage to your joint.
MRI. Magnetic resonance imaging (MRI) can help your doctor assess damage to the soft tissue structures around a dislocated joint.

Treatments and drugs

Treatment of the dislocation depends on the site and severity of your injury. Your doctor may try some gentle maneuvers to help your bones back into position — a process called reduction. Depending on the amount of pain and swelling, you may need a local anesthetic or even a general anesthetic before manipulation of your bones.

After your bones are back in place, any severe pain should improve. But your doctor may immobilize your joint with a splint or sling for several weeks. How long you wear the splint or sling depends on the nature and location of your dislocation. Your doctor may also prescribe a pain reliever or a muscle relaxant.

A gradual healing
After your splint or sling is removed, you'll begin a gradual rehabilitation program designed to restore your joint's range of motion and strength. Avoid strenuous activity with your injured joint until it has regained full movement and normal strength and stability.

Some dislocations, such as the hip, may need up to several months to heal.

If you've had a fairly simple dislocation without major nerve or tissue damage, your joint likely will return to a near-normal or fully normal condition. But trying to return to your pre-injury state too soon from such an injury may cause you to re-injure the joint or to dislocate it again.

When surgery is needed
You may need surgery if your blood vessels or nerves are damaged or if your doctor can't move your dislocated bones back into their correct positions. Surgery may also be necessary if you have had recurring dislocations, especially of the shoulder.

Prevention

To help prevent a dislocation:

Take precautions to avoid falls. Get your eyes checked on a regular basis, and if you're taking medications, ask your doctor if any of those drugs have the potential to make you dizzy. Also, be sure your home is well lighted and that you remove any potential tripping hazards from the areas where you walk.
Wear the suggested protective gear when you play contact sports.

Avoiding recurrence
Once you've dislocated a joint, you may be more susceptible to future dislocations. To avoid a recurrence, follow the specific strength and stability exercises that you and your doctor have discussed for your injury.

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Dislocation

MayoClinic.com Features