Dislocations

Introduction
Signs and Symptoms
Causes
Risk Factors
Screening and Diagnosis
Treatment
Prevention

A joint is a point 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. The 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. The cause is usually trauma, such as a fall or a hard blow. Dislocations are common injuries in contact sports, such as football and hockey, and in sports that may involve falls, such as downhill skiing, gymnastics and volleyball.

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 dislocated joints will return to normal function after several weeks of rest and rehabilitation. However, some joints, such as your shoulder and kneecap (patella), have an increased risk of repeat dislocation.

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 - in your foot for a dislocated knee or in your hand for a dislocated elbow.

Dislocations are caused by:

• Sports injuries. Dislocations are common injuries 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 source of dislocation.
• Falls. You may dislocate a joint during a fall.

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.

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, rarely, 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.

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.

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 come back too soon from such an injury may cause you to re-injure the joint or to dislocate it again.

In rare cases, 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 weak joints or ligaments and tend to have recurring dislocations.

To help prevent a dislocation:

• Take precautions to avoid falls.
• Wear protective gear when you play contact sports.

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.