Dislocation

Subject: Medical and Surgical Nursing I (Theory)

Overview

A joint that has been completely and permanently dislocated means that at least a portion of the supporting joint capsule and some of its ligaments have been damaged. Dislocations can occur due to falls, accidents, sports injuries, etc. It can be controlled by keeping still, using a splint, reducing activity, applying ice, using painkillers, etc. A break in the continuity of the bone is referred to as a fracture in medicine. Pain, loss of function, deformity, shortening, etc. are some of its symptoms. Management techniques include traction, open reduction and internal fixation, external fixation, functional casts or braces, and cast immobilization. Care for the patient when they are wearing a cast (observe signs of circulatory impairment – change in skin color and temperature, diminished distal pulses, pain, and swelling of the extremity, protect the cast from damage.)

Dislocation

An injury called a dislocation occurs when the ends of bones are pushed out of place. A joint that has been completely and permanently dislocated means that at least a portion of the supporting joint capsule and some of its ligaments have been damaged.

Major joints like the shoulder, hip, knee, elbow, or ankle may dislocate, as well as minor joints like the finger, thumb, or toe. The damage may cause the joint to become momentarily deformed and immobile as well as abrupt, intense pain and swelling.

Causes

  • Sports Injuries
    • Sports that entail contact, like football and hockey, as well as those that may include falls, such downhill skiing, gymnastics, and volleyball, can all result in dislocation.
  • Trauma Not Related to Sports
    • Dislocations frequently result from a forceful blow to a joint during a car collision.
  • Falls
    • During a fall, a person could dislocate a joint.

Risk Factors

  • Susceptibility to Falls
    • In the event that a person falls and utilizes their arms to brace for impact, they run the risk of dislocating a joint.
  • Heredity
    • Compared to the ligaments of most people, some people are born with ligaments that are looser and more prone to injury.
  • Sports Participations
  • Motor Vehicles Accidents

Tests and Diagnosis

  • X –ray
    • To confirm the dislocation, a joint x-ray is taken, which may show shattered bones or other joint damage.
  • MRI
    • Damage to the soft tissue support system surrounding a displaced joint can be evaluated with the aid of magnetic resonance imaging.

Management

  • Immobilization
    • Keep your hands off the displaced joints.
  • Application of Splint
    • Secure the injured joint in its current position with a splint or sling. A dislocated joint should not be moved or pushed back into position by force. The joint, as well as the muscles, ligaments, nerves, and blood vessels around, may suffer harm as a result.
  • Apply Ice to The Injured Joint
    • By reducing internal bleeding and the accumulation of fluids in and around the injured joint, applying ice can help relieve pain and swelling.
  • Reduction
    • To assist in moving the bones back into place during this process, some gentle movements are employed. Before manipulating bones, a local anesthetic or even a general anesthetic may be used, depending on how much pain and swelling there is.
  • Analgesics
    • Any extreme pain should lessen following the reduction process. However, analgesics or muscle relaxants might be used to treat pain if it persists.
  • Rehabilitation
    • A progressive rehabilitation program should be created to restore the joints' range of motion and strength after the splint is removed.

Complications

A joint dislocation's potential complications include

  • The muscles, ligaments, and tendons that support the damaged joint are torn.
  • Damage to the blood vessels or nerves in or near the joint.
  • Vulnerability to further harm after a severe or frequent dislocation
  • As people age, they develop arthritis in the damaged joint.

 References

  • greenleaffootandankle.com/dislocations
  • Mandal, G. (August 2013). A Textbook of Adult Health Nursing (2nd ed.). Dilllibazar kathmandu: Makalu publication house. Retrieved August 2013
  • mayoclinic.org/first-aid/first-aid-dislocation/basics/art-20056693
  • vocabulary.com/lists/333190
Things to remember
  • Major joints like the shoulder, hip, knee, elbow, or ankle may dislocate, as well as minor joints like the finger, thumb, or toe.
  • Due to heredity, some people are born with ligaments that are more flimsy and vulnerable to damage than the majority of people.
  • The muscles, ligaments, and tendons that support the damaged joint are torn.
  • Damage to the blood vessels or nerves in or near the joint.
  • A break in the continuity of the bone is referred to as a fracture in medicine.
  • Traction: A bone or bones are typically pulled gently and steadily into alignment using traction.
  • Keep an eye out for any signs of thrombophlebitis and notify a senior right away.
  • To avoid pressure sores, offer skin care.
Questions and Answers

An injury called a dislocation occurs when the ends of bones are pushed out of place. A joint that has been completely and permanently dislocated means that at least a portion of the supporting joint capsule and some of its ligaments have been damaged.

Major joints like the shoulder, hip, knee, elbow, or ankle may dislocate, as well as smaller joints like the finger, thumb, or toe. The injury may cause the joint to become temporarily deformed and immobile as well as sudden, intense pain and swelling.

 

 

Causes

  • Sports Injuries: Dislocation can occur in contact sports, such as football and hockey, and the sports that may involve falls, such as downhill, skiing, gymnastics, and volleyball.
  • Trauma not related to sports: A hard blow to a joint during a motor vehicle accident is a common cause of dislocation.
  • Falls : Person may dislocate a joint during a fall.

Management

  • Immobilization: Do not move the dislocated joints.
  • Application of splint: Splint or sling the affected joint in its current position. Don’t try to move a dislocated joint or force it back into place. This can damage the joint and its surrounding muscles, ligaments, nerves and even blood vessels.
  • Apply ice to the injured joint: Applying ice to the injured joint can help reduce pain and swelling by controlling internal bleeding and the buildup of fluids in and around the injured joint.
  • Reduction: During this process, some gentle maneuvers is used to help bones back into position. Depending on the amount of the pain and swelling, a local anesthetic or even a general anesthetic before manipulation of bones may be used.
  • Analgesics: After the reduction process, any severe pain should improve. But if pain continues, analgesic or a muscle relaxant can be used to relieved pain.
  • Rehabilitation: After the splint is removed a gradual rehabilitation program should be designed to restore the joints range of motion and strength.

Dislocation

A dislocation is an injury in which the ends of bones are forced from their normal positions. Dislocation is a complete and persistent displacement of a joint in which at least part of the supporting joint capsule and some of its ligaments are disrupted.

Dislocation may occur in major joints, such as shoulder, hip, knee, elbow or ankle or in smaller joints, such as a finger, thumb or toe. The injury will temporarily deform and immobilize the joint and may result in sudden and severe pain and swelling.

Causes

  • Sports Injuries: Dislocation can occur in contact sports, such as football and hockey, and the sports that may involve falls, such as downhill, skiing, gymnastics, and volleyball.
  • Trauma not related to sports: A hard blow to a joint during a motor vehicle accident is a common cause of dislocation.
  • Falls:  Person may dislocate a joint during a fall.

Risk Factors

  • Susceptibility to Falls: Experiencing a fall exposes the person to the possibility of a dislocated joint if he or she uses his or her arms to brace for impact.
  • Heredity: Some people are born with ligaments that are looser and more prone to injury than those of most people.
  • Sports Participations
  • Motor Vehicles Accidents

Tests and Diagnosis

  • X –ray: An x- ray of the joint is used to confirm the dislocation and may reveal broken bones or other damage to the joint.
  • MRI: Magnetic Resonance Imaging can help to assess damage to the soft tissue structure around a dislocated joint.

Management

  • Immobilization: Do not move the dislocated joints.
  • Application of Splint: Splint or sling the affected joint in its current position. Don’t try to move a dislocated joint or force it back into place. This can damage the joint and its surrounding muscles, ligaments, nerves and even blood vessels.
  • Apply ice to the injured joint: Applying ice to the injured joint can help reduce pain and swelling by controlling internal bleeding and the buildup of fluids in and around the injured joint.
  • Reduction: During this process, some gentle maneuvers is used to help bones back into position. Depending on the amount of the pain and swelling, a local anesthetic or even a general anesthetic before manipulation of bones may be used.
  • Analgesics: After the reduction process, any severe pain should improve. But if pain continues, analgesic or a muscle relaxant can be used to relieved pain.
  • Rehabilitation: After the splint is removed a gradual rehabilitation program should be designed to restore the joints range of motion and strength.

Complications: Complication of a joint dislocation may include:

  • Tearing of the muscles, ligaments and tendons that reinforce the injured joint.
  • Damage to the nerve or blood vessels in or around the joint.
  • Susceptibility to re-injury if someone has a severe dislocation or repeated dislocation
  • Development of arthritis in the affected joint as age advances.

 

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