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Understanding Joint Dislocations and Treatments

A joint dislocation is the separation of two bones where they meet at a joint, causing the bone to be out of its normal position. A subluxation is a partial dislocation. Dislocations are usually caused by trauma like falls or blows and present with pain, swelling, and limited movement at the joint. Treatment involves reducing the dislocation by manipulating the joint back into position, often requiring sedation or anesthesia, followed by immobilization. Common dislocations include the shoulder, elbow, hip, ankle, and fingers. Proper technique and post-reduction imaging is important to ensure successful reduction.

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Available Formats
Download as PPTX, PDF, TXT or read online on Scribd

Topics covered

  • periarticular fracture,
  • ankle dislocation,
  • ligament damage,
  • joint recovery,
  • treatment protocols,
  • nomenclature for dislocations,
  • sedation techniques,
  • fall injuries,
  • rehabilitation,
  • dislocation signs
493 views35 pages

Understanding Joint Dislocations and Treatments

A joint dislocation is the separation of two bones where they meet at a joint, causing the bone to be out of its normal position. A subluxation is a partial dislocation. Dislocations are usually caused by trauma like falls or blows and present with pain, swelling, and limited movement at the joint. Treatment involves reducing the dislocation by manipulating the joint back into position, often requiring sedation or anesthesia, followed by immobilization. Common dislocations include the shoulder, elbow, hip, ankle, and fingers. Proper technique and post-reduction imaging is important to ensure successful reduction.

Uploaded by

ayu
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PPTX, PDF, TXT or read online on Scribd

Topics covered

  • periarticular fracture,
  • ankle dislocation,
  • ligament damage,
  • joint recovery,
  • treatment protocols,
  • nomenclature for dislocations,
  • sedation techniques,
  • fall injuries,
  • rehabilitation,
  • dislocation signs

JOINT DISLOCATIONS

dr. Rudi Febrianto


Sp.OT
JOINT DISLOCATIONS

Definition
A dislocation is a separationoftwo bones
where they meet at a joint. A dislocated
bone is no longer in its normal position. A
dislocation may also cause ligament or
nerve damage. Dislocations may be
associated with a periarticular fracture
SUBLUXATION

A subluxation is
an incomplete or partial
dislocation. For example, a
nursemaid's elbow is the
subluxation of the head of the
radius in the elbow.
DISLOCATION CAUSES

Dislocationsare usually caused by a


sudden impact to the joint. This
usually occurs following a blow, fall,
or other trauma
Predisposing factor of
dislocation
Susceptibility to fall
Heredity
Sportparticipation
Motor vehicle accident
DISLOCATION SYMPTOMS
History of injury
Pain
Swelling
Difficulty
moving the joint
Numbness and paresthesias
DISLOCATION SIGNS
Visiblyout-of-place, discolored, or
misshapen joint
Limited joint movement
Swollen or bruised
Intensely painful, especially if you try
to use the joint or bear weight on it
or move it.
Decreased sensation distal to the
joint
Decreased pulse, cool extremity
NOMENCLATURE FOR
DISLOCATIONS
Name the JOINT
Name the dislocation by the position
of the DISTAL FRAGMENT in
relation to the proximal fragment
Add FRACTURE to the name if
there is a periarticular fracture.
Add OPEN if a wound communicates
with the dislocation
RADIOGRAPHS
Two planes at 90
degrees to each
other
Good quality
Standard views
See the entire joint

Dislocated Elbow
TREATMENT
Reduce the dislocation as soon as
possible
Check Neurovascular function distally
Take post reduction radiograph
Immobilize the joint
REDUCTION TECHNIQUE
StartIV
Give sedation
Apply traction force
Manipulate joint
Posterior dislocation of
Elbow
Fallon the hand with elbow slightly
flexed or severe hyperextension
injury
Clinical feature : humerus driven
forward througt anterior capsule,
there is always extensive soft tissue
injury,
Elbow is grossly swollen, olecranon is
readly palpable posteriorly
Complication : median nerve injury,
Reduction technique
Reduction technique
Shoulder dislocation
Anterior or posterior dislocation
Shoulder joint is dependent stability
on the joint capsule and surrounding
muscle
The glenoid cavity being small in
relation to head of humerus
Anterior dislocation of
shoulder
Incident is 95% of all dislocation of
shoulder
Caused by forced external rotation
and extension of shoulder
Humeral head driven forward and
frequently avulses the cartilagenous
glenoid labrum and capsule from
anterior margin of the glenoid
cavityThe bankart lesion
Patient immediately aware
Treatment
prone position in 10 minute wait until
spontaneous reposition to normal
Hippocrates technique
Reduction with general anesthesia
Complication
Recurrent
Traction injury of axillary nerve
SHOULDER REDUCTION

Sedation
Apply traction and
counter traction
Lift humeral head
into the glenoid
Posterior dislocation of
shoulder
posterior dislocation of the
hip
Dashboard injury or fall on the knee
flexed
Usually jeopardize blood supply to
femoral heademergency and need to
reduce as soon as possible to prevent
avascular necrosis
To lower incident of avascular necrosis
need to be reduced in first 8 hours
Clinical feature : hip in flexion,
adduction, internal rotation and
shortening
Hip reduction
Hip reduction
HIP REDUCTION
Sedation
Relaxation,
flexion, traction,
and rotation
Gentle and
atraumatic

Relocationshouldbepalpableandpermitsignificantly
improvedROM.Thisoftenrequiresverydeepsedation.
Anterior dislocation of the
hip
Ankle dislocation
PIPJ DISLOCATION

Hyper-extend the joint, apply traction then flex the joint. Follow with a
post reduction x-ray, check for avulsion fracture.
THANK YOU

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