What is dislocation?
Physicians understand a dislocation to be an injury to the joints, in which the joint-forming bone ends usually completely lose the otherwise existing contact with each other (this is called dislocation).
This condition is commonly referred to as dislocation or bulging of the respective joint. It is a mostly temporary malposition of the bones, which must be treated medically. Basically, almost all joints in the body can be affected by a dislocation.
However, dislocations of the shoulder, elbow and knee joint are particularly common. Even dislocated finger or temporomandibular joints are not uncommon. A dislocation is a severe injury to the affected joint and can lead to bone fractures, especially during growth.
The causes of a dislocation lie in most cases in an indirect impact on the affected joint. This may include a fall on the arm / shoulder, for example.
Even with some sports, it can lead to so-called overstretch injuries, which have a dislocation, for example, the finger joints result. A jerky and violent pulling on fingers, arms or legs can also lead to a joint being injured accordingly.
If a joint has been repeatedly affected by a dislocation, it may under certain circumstances remain unstable in comparison to other joints - as a result, so-called habitual dislocations occur occasionally even without violence.
Symptoms, complaints & signs
A dislocation usually causes severe pain. Divergence of bone ends can cause damage to the surrounding ligaments, vessels, nerves and muscles. As a result, the ability to move is usually greatly reduced, often a bruise develops. As a result of the pain and mechanical restriction, the patients keep the affected limb in a rest position.
If it comes in the course of dislocation to nerve injuries, it can lead to discomfort or paralysis in other parts of the body. Possible, for example, a tingling sensation in the fingers or numbness in the toes. The implications of dislocation in the first place depend primarily on where it is located and which joints are involved. The joint socket is perceived by those affected and the doctor as "empty".
Usually a feather of the joint can be determined. The external signs are accompanied by a reddening of the affected area and occasionally by visible deformations in the surrounding regions. In addition, a dislocation can lead to hematomas or bruises. This often results in circulatory disorders, skin changes and other complaints. The symptoms of a dislocation can vary widely, depending on where the dislocation is located and whether nerves, ligaments or muscles are injured.
Diagnosis & History
A dislocation can often already be diagnosed by the attending physician due to the present visual deformity of the affected joint. The condyle often stands out clearly. There may be swelling and bruising.
A dislocation is usually accompanied by pain, which leads to a restraint. If the symptoms are not clear, an X-ray of each region of the body can help with the diagnosis.
If a dislocation remains untreated, it can lead to permanent joint instability and the already mentioned habitual dislocations or more frequent fractures of the joints. As a late consequence threatens osteoarthritis or permanent malposition of the joint.
First and foremost, dislocation leads to relatively severe pain in the joints. The joints themselves are swollen and may also show bruises. In general, the further course of this complaint depends strongly on the cause of the dislocation and the affected area, so that a general course of the disease can not be predicted. In many cases, the joint surfaces are in a wrong position after dislocation, resulting in limitations in the patient's movement and everyday life.
In general, the diagnosis of dislocation is relatively easy and fast, as the joint protrudes visibly. Therefore, early treatment of this complaint is possible. However, it does not come to a self-healing. If the dislocation is not treated properly, osteoarthritis can develop as well.
Not infrequently, dislocation of the nerves can occur as a result of the dislocation, so that the patients suffer from paralysis or other emotional disorders and are thus restricted in everyday life. The treatment takes place through surgery and in most cases leads to success. Complications do not occur. Also, the life expectancy of the patient is 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. People should consult the doctor if the symptoms are acute and are getting worse. If it comes as a result of a fall or a sports injury to severe pain or even a fracture, the person must be taken to a hospital. Beforehand, the affected part of the body must first be supplied, ideally by a sports physician or first responder with appropriate first aid training. Persons with congenital connective tissue weakness or distensible ligament structures suffer dislocations very quickly.
Even in old age and in connection with osteoarthritis or rheumatic diseases, there are more and more dislocations. The excessive overstretching of ligaments and joints permanently weakens the joint, which is why caution is required after recovery. If there is a suspicion of a new dislocation, the family doctor must be informed immediately. In addition to the general practitioner can be gone with a dislocation to the orthopedist, chiropractor or sports physician. For severe symptoms, a physiotherapeutic treatment is necessary.
Treatment & Therapy
If the attending physician has diagnosed a dislocation, he can initiate appropriate treatment. First and foremost, the malposition of the joint-forming bone must be corrected.
Colloquially, this process is also referred to as "narrowing". It should only be done by a specialist, as excessive force or jerky movement can damage the joint itself or surrounding nerves or vessels. This non-painful procedure may need to be performed under general anesthesia.
Subsequently, the affected joint should be immobilized. An X-ray shows if the reduction was successful and if there are other injuries. If the joint can not be restored to its original position as expected, surgery must be performed to correct this. Surgery is often necessary even if the dislocation is accompanied by a fractured bone at the same time.
Following dislocation, the joint should not be overly stressed for several weeks or even months. A complete immobilization over a longer period of time is not advisable. If the injury has occurred during exercise, it is often necessary to temporarily discontinue training to ensure complete restoration of joint stability. Corresponding physiotherapeutic exercises can support the healing process.
Outlook & Forecast
Basically, the dislocation is easy to treat. Therefore, most patients receive a favorable prognosis. In a well-established treatment plan and the cooperation of the affected person can usually be documented after a few months, a complaint-free. It is important that a medical treatment is used and during the healing process, no excessive stress on the affected joint takes place.
Since the disorder is a dislocation of a joint, orthopedic and physiotherapeutic treatment should be used. Otherwise, lifelong impairments and a restriction of natural movement possibilities are threatened. Often there are subsequent disorders that are discovered and cured during treatment. The prognosis for a complaint-free condition becomes unfavorable if permanent damage of the joint occurred or it repeatedly came to a dislocation during the life. In these cases, changes in the design of the everyday or professional life must take place, since the movement options are limited and the physical services can no longer be fully provided.
If surgery is performed, it is associated with the usual risks and side effects. If complications occur during surgery or the healing process, the prognosis often deteriorates. In addition, the risk of complications increases, as an increase in emotional stress is observed.
Since dislocation usually occurs as a result of acute trauma, it is difficult to prevent. However, if there is already a known vulnerability of certain joints, it is advisable not to burden them excessively. If a dislocation occurs, a doctor should be consulted immediately. Only in this way can it be ensured that the important joint stability can be fully restored after the traumatic injury.
You can do that yourself
Self-help measures in the context of a dislocation exist in the care of the affected joint and if necessary in the introduction of pain-relieving measures. So it is advised for sufferers that they follow the medical instructions and allow a rest position of the joint. In fact, the best self-help in the presence of a dislocation is to spare the area for several weeks after re-setting.
It is not advisable in the case of an acute dislocation to try as a layman to re-orient. The possibilities of causing damage to the joint or surrounding tissue are manifold. Exceptions here are repeatedly dislocated kneecaps: These can often be repositioned after technical instruction.
Overall, a dislocation occurring should be met quickly by means of cooling, as far as pain and swelling occur. To avoid further swelling, try to store or hold the appropriate spot. The coolant must not rest directly on the skin. Also fixing the dislocated site by means of an assistant bandage or the like is useful up to the medical examination and treatment. Chronic dislocation in joints is not correctable through self-help. Here can be acted only analgesic.