How to treat dislocated joints; causes of dislocated joints

A joint becomes dislocated when the bone ends are knocked or pulled out of position. Suspect dislocation if the joint suddenly doesn’t work normally, if moving or putting weight on it is painful, or if it starts to swell and discolor. A dislocated limb or digit may look different from its counterpart; it may have a lump or a distorted angle.

Dislocation occurs most often in a shoulder or the jaw, but it can happen to any joint: toes, fingers, ankles, wrists, elbows, hips, even joints between vertebrae. Get medical help right away; the sooner the treatment, the lower the risks. Meanwhile, keep the injured person comfortable, using the same cushioning and immobilizing techniques as for breaks.

It usually takes a considerable blow to dislocate a joint, so other injuries are likely: stretching or tearing of ligaments that hold the joint in position; damage to the joint capsule- the surrounding membrane; crushed muscles, nerves, and blood vessels; perhaps a broken or chipped bone. What to do-and not to do Don’t try to reposition the joint or to straighten an arm or leg. Remedial steps should only be taken by professionals, guided by X-rays. Depending on the extent of swelling and other injuries, the procedure may require anesthesia. You should apply ice packs to relieve swelling and pain, but in case anesthesia is required, don’t give the injured person food or drink.

Relief is often so great when the joint is returned to its normal position (it may even “pop” back by itself) that people are tempted to consider the injury healed. Far from it; damaged ligaments and tissues require weeks to heal. A premature return to normal activities may cause pain and swelling to recur. A person may even risk permanent damage, recurrent dislocations, or the beginning of arthritis in the joint.

Sometimes dislocations occur for no apparent reason. A too-wide yawn can dislocate the jaw; a knee might “pop” unexpectedly; a shoulder may dislocate during some quite ordinary activity. There may be an underlying cause, such as a previous injury, or a predisposition because a joint was always abnormally shaped.

Young children often suffer what is called “pulled elbow”-a term to be taken literally, since the dislocation is caused by pulling a child along by an arm. (A shoulder can be similarly dislocated by yanking a child off the ground by one arm.) Such a dislocation, being only partial, doesn’t show up on an X-ray. It can be slipped back into place by a simple maneuver the doctor performs in the office.