Dislocations

Dislocations are joint injuries that force the ends of your bones out of position.

Dislocations are joint injuries that force the ends of your bones out of position. The cause is often a fall or a blow, sometimes from playing a contact sport. You can dislocate your ankles, knees, shoulders, hips, elbows and jaw. You can also dislocate your finger and toe joints. Dislocated joints often are swollen, very painful and visibly out of place. You may not be able to move it.

A dislocated joint is an emergency. If you have one, seek medical attention. Treatment depends on which joint you dislocate and the severity of the injury. It might include manipulations to reposition your bones, medicine, a splint or sling, and rehabilitation. When properly repositioned, a joint will usually function and move normally again in a few weeks. Once you dislocate a shoulder or kneecap, you are more likely to dislocate it again. Wearing protective gear during sports may help prevent dislocations.

It may be hard to tell a dislocated joint from a broken bone. Both are emergencies that need first aid treatment.

Most dislocations can be treated in a doctor's office or emergency room. You may be given medicine to make you sleepy and to numb the area. Sometimes, general anesthesia that puts you into a deep sleep is needed.

When treated early, most dislocations do not cause permanent injury.

You should expect that:

  • Injuries to the surrounding tissues generally take 6 to 12 weeks to heal. Sometimes, surgery to repair a ligament that tears when the joint is dislocated is needed.
  • Injuries to nerves and blood vessels may result in more long-term or permanent problems.

Once a joint has been dislocated, it is more likely to happen again. After being treated in the emergency room, you should follow up with an orthopaedic surgeon (a bone and joint doctor).

To help prevent injuries in children:

Create a safe environment around your home.
Help prevent falls by placing gates at stairways and keeping windows closed and locked.
Keep a watchful eye on children at all times. There is no substitute for close supervision, no matter how safe the environment or situation appears to be.
Teach children how to be safe and look out for themselves.

To help prevent dislocations in adults:

To avoid falls, do not stand on chairs, countertops, or other unstable objects.
Eliminate throw rugs, especially around older adults.
Wear protective gear when participating in contact sports.

For all age groups:

Keep a first aid kit handy.
Remove electrical cords from floors.
Use handrails on staircases.
Use nonskid mats on the bottom of bathtubs and do not use bath oils.

Dislocations are usually caused by a sudden impact to the joint. This usually occurs following a blow, fall, or other trauma.

A dislocated joint may be:

  • Accompanied by numbness or tingling at the joint or beyond it
  • Very painful, especially if you try to use the joint or put weight on it
  • Limited in movement
  • Swollen or bruised
  • Visibly out of place, discolored, or misshapen

Nursemaid's elbow, or pulled elbow, is a partial dislocation that is common in toddlers. The main symptom is pain so that the child doesn’t want to use the arm. This dislocation can be easily treated in a doctor's office.

First aid steps to take:

  1. Call 911 before you begin treating someone who may have a dislocation, especially if the accident that caused the injury may be life threatening.
  2. If the person has a serious injury, check their airway, breathing, and circulation. If necessary, begin CPR, or bleeding control.
  3. Do not move the person if you think that their head, back, or leg has been injured. Keep the person calm and still.
  4. If the skin is broken, take steps to prevent infection. Do not blow on the wound. Rinse the area gently with clean water to remove any dirt you can see, but do not scrub or probe. Cover the area with sterile dressings before immobilizing the injured joint.
  5. Splint or sling the injured joint in the position in which you found it. Do not move the joint. Also immobilize the area above and below the injured area.
  6. Check blood circulation around the injury by pressing firmly on the skin in the affected area. It should turn white, then regain color within a couple of seconds after you stop pressing on it. To reduce the risk of developing infection, do not do this step if the skin is broken.
  7. Apply ice packs to ease pain and swelling, but do not put ice directly on the skin. Wrap the ice in a clean cloth.
  8. Take steps to prevent shock. Unless there is a head, leg, or back injury, lay the victim flat, elevate their feet about 12 inches, and cover the person with a coat or blanket.