Dislocation or Subluxation

Dislocation of a joint occurs when ends of two or more adjacent bones no longer touch each other. A subluxation is a minor form of a dislocation, in which two or more adjacent bones are no longer properly aligned. The most common joints susceptible to a dislocation are the shoulder, kneecap, and fingers.

SYMPTOMS

  • Sudden pain at the time of injury.

  • Noticeable deformity in the area of the joint.

  • Limited range of motion.

CAUSES

  • Usually a traumatic injury that stretches or tears ligaments that surround a joint and hold the bones together.

  • Condition present at birth (congenital) in which the joint surfaces are shallow or abnormally formed.

  • Joint disease such as arthritis or other diseases of ligaments and tissues around a joint.

RISK INCREASES WITH:

  • Repeated injury to a joint.

  • Previous dislocation of a joint.

  • Contact sports (football, rugby, hockey, lacrosse) or sports that require repetitive overhead arm motion (throwing, swimming, volleyball).

  • Rheumatoid arthritis.

  • Congenital joint condition.

PREVENTION

  • Warm up and stretch properly before activity.

  • Maintain physical fitness:

  • Joint flexibility.

  • Muscle strength and endurance.

  • Cardiovascular fitness.

  • Wear proper protective equipment and ensure correct fit.

  • Learn and use proper technique.

PROGNOSIS

This condition is usually curable with prompt treatment. After the dislocation has been put back in place, the joint may require immobilization with a cast, splint, or sling for 2 to 6 weeks, often followed by strength and stretching exercises that may be performed at home or with a therapist.

RELATED COMPLICATIONS

  • Damage to nearby nerves or major blood vessels, causing numbness, coldness, or paleness.

  • Recurrent injury to the joint.

  • Arthritis of affected joint.

  • Fracture of joint.

TREATMENT

Treatment initially involves realigning the bones (reduction) of the joint. Reductions should only be performed by someone who is trained in the procedure. After the joint is reduced, medicine and ice should be used to reduce pain and inflammation. The joint may be immobilized to allow for the muscles and ligaments to heal. If a joint is subjected to recurrent dislocations, surgery may be necessary to tighten or replace injured structures. After surgery, stretching and strengthening exercises may be required. These may be performed at home or with a therapist.

MEDICATION

  • Patients may require medicine to help them relax (sedative) or muscle relaxants in order to reduce the joint.

  • If pain medicine is necessary, nonsteroidal anti-inflammatory medicines, such as aspirin and ibuprofen, or other minor pain relievers, such as acetaminophen, are often recommended.

  • Do not take pain medicine for 7 days before surgery.

  • Prescription pain relievers may be necessary. Use only as directed and only as much as you need.

SEEK MEDICAL CARE IF:

  • Symptoms get worse or do not improve despite treatment.

  • You have difficulty moving a joint after injury.

  • Any extremity becomes numb, pale, or cool after injury. This is an emergency.

  • Dislocations or subluxations occur repeatedly.