DISLOCATION OR SUBLUXATION

General Information

DEFINITION--Dislocation is injury to a joint so that adjoining bones no longer touch each other. Subluxation is a minor dislocation. Joint surfaces still touch, but not in normal relation to each other.

BODY PARTS INVOLVED--Bones in joints, especially the jaw, shoulder, knee and spine. Some infants are born with a hip dislocation.

SEX OR AGE MOST AFFECTED--Both sexes; all ages.

SIGNS & SYMPTOMS

• Sudden joint pain, swelling or deformity after an injury.
• Limited or absent movement around a joint.

CAUSES

• Injury that stretches or tears ligaments that surround a joint and hold the bones together.
• Shallow or abnormally formed joint surfaces (congenital).
• Rheumatoid arthritis or other diseases of ligaments and tissue around a joint.

RISK INCREASES WITH

• Rheumatoid arthritis.
• Family history of congenital hip dislocation.
• Repeated injury to a joint.

HOW TO PREVENT

• If you are involved in heavy work or strenuous sports, learn to protect the involved joints. Use protective devices, such as wrapped elastic bandages, tape wraps, knee or shoulder pads, and special support stockings.
• Infants should be examined for congenital hip dislocation at birth and at "well-baby" checkups.

What To Expect

DIAGNOSTIC MEASURES--

• Your own observation of symptoms.
• Medical history and physical exam by a doctor.
• X-rays of the joint and adjacent bones.

APPROPRIATE HEALTH CARE

• Self-care after diagnosis.
• Doctor's treatment. This may include manipulating the joint to reposition the bones.
• Surgery to restore the joint to its normal position (sometimes). Recurring dislocation may require surgical reconstruction or replacement of the joint.

POSSIBLE COMPLICATIONS--Damage to nearby nerves or major blood vessels, causing numbness, coldness and paleness.

PROBABLE OUTCOME--Usually curable with prompt treatment. After the dislocation has been corrected, the joint may require immobilization with a cast or sling for 2 to 8 weeks.

How To Treat

GENERAL MEASURES----Immediately after injury:

• Apply ice packs to the involved joint to prevent swelling.
• Use a splint or sling to prevent movement while transporting the injured person to the doctor.
• If your doctor puts a cast on the joint, see Care of Casts in Appendix.

MEDICATION--Your doctor may prescribe:

• General anesthesia or muscle relaxants to make joint manipulation possible.
• Acetaminophen or aspirin to relieve moderate pain.
• Narcotic pain relievers for severe pain.

ACTIVITY--Resume your normal activities gradually after treatment.

DIET--Drink only water before manipulation or surgery to correct the dislocation. Solid food makes general anesthesia more hazardous.

Call Your Doctor If

• You have difficulty moving a joint after injury.
• Any extremity becomes numb, pale or cold after injury. This is an emergency!
• Dislocations occur repeatedly that you can "pop" back into normal position.