A dislocation, colloquially also called dislocation or dislocation, is an injury to the joints that usually occurs as a result of a fall or an abrupt overload. This usually results in a complete loss of contact between the bones forming the joint. The shoulder and elbow joints are particularly frequently affected in this case.
What is dislocation?
By dislocation, physicians mean an injury to the joints in which the ends of the bones forming the joint usually completely lose contact with each other (this is called dislocation). This condition is also commonly referred to as dislocation or dislocation of the joint in question. It is usually a temporary misalignment of the bones that requires medical treatment. In principle, dislocation can affect almost any joint in the body. However, dislocations of the shoulder, elbow and knee joints occur particularly frequently. Dislocated finger or jaw joints are also not uncommon. A dislocation is a serious injury to the affected joint and can lead to bone fractures, especially during growth.
Causes
In most cases, the causes of a dislocation are due to indirect force on the affected joint. Among other things, this can involve a fall on the arm/shoulder, for example. Also in some sports, so-called hyperextension injuries can occur, which result in a dislocation of the finger joints, for example. Jerky and violent pulling on fingers, arms or legs can also cause a joint to be injured accordingly. If a joint has already been affected by a dislocation several times, it may remain unstable compared to other joints – as a result, so-called habitual dislocations occasionally occur even without force.
Symptoms, complaints, and signs
A dislocation usually causes severe pain. The drifting apart of the bone ends can cause damage to the surrounding ligaments, vessels, nerves and muscles. As a result, mobility is also normally severely reduced, and a hematoma often develops. As a result of the pain and mechanical restriction, patients hold the affected limb in a protective posture. If nerve damage occurs in the course of the dislocation, it can lead to insensations or paralysis in other regions of the body. For example, tingling in the fingers or numbness in the toes is possible. The exact effects of the dislocation depend primarily on where it is localized and which joints are involved. The joint socket is perceived as “empty” by the affected person and by the doctor. In most cases, springing of the joint can be detected. External signs are accompanied by redness of the affected area and occasionally visible deformities in the surrounding regions. Furthermore, dislocation can lead to hematoma or bruising. This often results in circulatory problems, skin changes, and other discomfort. Symptoms of dislocation can vary widely depending on where the dislocation is located and whether nerves, ligaments or muscles are injured.
Diagnosis and progression
A dislocation can often already be diagnosed by the treating physician on the basis of the present visual deformation of the affected joint. In this case, the joint head is often clearly protruding. Swelling and bruising may occur. Luxation is usually accompanied by pain, which leads to a protective posture. If the symptoms are not clear, an X-ray of the respective body region can help with the diagnosis. If a dislocation remains untreated, it can lead to permanent joint instability and the habitual dislocations already mentioned, or even more frequent bone fractures in the area of the joints. As a late consequence, arthrosis or a permanent malposition of the joint is imminent.
Complications
First and foremost, dislocation leads to relatively severe pain at the joints. The joints themselves are swollen and may also show bruising. As a rule, the further course of this complaint depends greatly on the cause of the dislocation and the affected area, so that a general course of the disease cannot be predicted. In many cases, the joint surfaces are in an incorrect position after the dislocation, so that there are restrictions in the patient’s movement and everyday life.As a rule, the diagnosis of the dislocation is relatively simple and quick, because the joint is visibly protruding. Therefore, early treatment of this complaint is also possible. However, this does not result in self-healing. If the dislocation is not treated properly, arthrosis can also develop. It is not uncommon for the dislocation to cause nerve entrapment, so that patients suffer from paralysis or other sensory disturbances and are thus restricted in their daily lives. The treatment is carried out by means of a surgical intervention and is successful in most cases. Complications do not occur. The patient’s life expectancy is also not affected by the dislocation.
When should you go to the doctor?
Severe pain in the area of bones and joints must be clarified immediately. Affected individuals should consult the doctor if the symptoms are acute and quickly become more severe. If severe pain or even a fracture occurs as a result of a fall or sports injury, the affected person must be taken to a hospital. Before this happens, the affected body part must first be treated, ideally by a sports physician or a first-aider with appropriate first-aid training. People with congenital connective tissue weakness or overstretchable ligament structures suffer dislocations particularly quickly. Dislocations also occur more frequently in old age and in connection with osteoarthritis or rheumatic diseases. The severe overstretching of ligaments and joints permanently weakens the joint, which is why caution is required even after recovery. If a new dislocation is suspected, the general practitioner must be informed immediately. In addition to the general practitioner, a dislocation can be taken to an orthopedist, chiropractor or sports medicine specialist. In case of severe discomfort, physiotherapeutic treatment is necessary.
Treatment and therapy
Once the attending physician has diagnosed a dislocation, he or she can initiate appropriate treatment. First and foremost, the misalignment of the joint-forming bones must be corrected. Colloquially, this procedure is also referred to as “setting”. It should only be performed by a specialist, as excessive force or jerky incorrect movement can damage the joint itself or surrounding nerves or vessels. Under certain circumstances, this procedure, which is not painless, must be performed under anesthesia. The affected joint should then be immobilized. An x-ray will reveal whether the reduction (setting) was successful and whether any other injuries may exist. If the joint cannot be returned to its original position as expected, surgery must take place to correct this. Surgery is also often necessary if the dislocation is accompanied by a fracture at the same time. Following a dislocation, the joint should not be subjected to excessive stress for several weeks or even months. However, complete immobilization over a longer period of time is not advisable. If the injury occurred during sports, it is often necessary to temporarily stop training to ensure full recovery of joint stability. Appropriate physiotherapy exercises can support the healing process.
Outlook and prognosis
In principle, dislocation is readily treatable. Therefore, most patients receive a favorable prognosis. With a well-established treatment plan and the cooperation of the affected person, freedom from symptoms can usually be documented after a few months. It is important that medical treatment is sought and that no excessive stress is placed on the affected joint during the healing process. Since the disorder is a dislocation of a joint, orthopedic as well as physiotherapeutic treatment should be applied. Otherwise, there is a risk of lifelong impairment and restriction of natural movement possibilities. Frequently, secondary disorders occur, which are discovered and cured during treatment. The prognosis for freedom from symptoms becomes less favorable if permanent damage to the joint has occurred or if dislocation has occurred repeatedly in the course of life. In these cases, changes must take place in the organization of everyday or professional life, since the possibilities of movement are restricted as well as the physical performance can no longer be fully achieved.If a surgical procedure is performed, it is associated with the usual risks and side effects. If complications occur during the operation or the healing process, the prognosis often deteriorates. In addition, the risk of secondary diseases increases, as an increase in emotional stress can be observed.
Prevention
Because dislocation usually occurs as a result of acute force, it is difficult to prevent. However, if there is already a known susceptibility of certain joints, it is advisable not to place excessive stress on them. If a dislocation occurs, a doctor should be consulted immediately. This is the only way to ensure that the important joint stability can be fully restored after the traumatic injury.
Aftercare
Dislocation primarily results in severe joint pain, which can sometimes persist even after acute treatment. Therefore, aftercare is aimed at relieving this pain, which is sometimes initially resolved with medication. In addition, those affected should take it easy and avoid physical exertion as far as possible. The course of the disease cannot be predicted, since the symptoms of a dislocation depend on the cause of the dislocation. Thus, some may be more severely afflicted with after-effects than others. Help and support from family members is needed for mastering everyday things. In most cases, the dislocation can be successfully treated. Life expectancy is not shortened by the dislocation.
What you can do yourself
Self-help measures in connection with a dislocation consist of sparing the affected joint and, if necessary, initiating pain-relieving measures. For example, it is advised for affected individuals to follow medical instructions and allow the joint to rest. In fact, the best self-help measure in the presence of a dislocation is to rest the area for several weeks after re-dislocation. It is not advisable for a layperson to attempt to re-dislocate in the event of an acute dislocation. The possibilities of causing damage to the joint or surrounding tissue are manifold. Exceptions are always luxated patellae: These can often be reduced again themselves after professional instruction. All in all, a dislocation that occurs should be countered quickly by means of cooling, insofar as pain and swelling occur. In order to avoid further swelling, an attempt should be made to elevate or hold the corresponding area. The coolant must not be applied directly to the skin. Fixation of the dislocated area by means of an auxiliary bandage or similar is also advisable until medical examination and treatment. Chronic joint dislocation cannot be corrected by self-help measures. Here, only pain-relieving measures can be taken.
