A dislocation, colloquial too contortion or Dislocation is an injury to the joints that usually occurs as a result of a fall or an abrupt overload. This usually leads to a complete loss of contact between the bones forming the joint. The shoulder and elbow joints are particularly often affected.
What is dislocation?
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Under one dislocation Doctors understand an injury to the joints in which the joint-forming bone ends usually completely lose contact with each other (this is called dislocation).
This condition is generally referred to as dislocation or dislocation of the respective joint. It is mostly a temporary misalignment of the bones that requires medical treatment. In principle, almost all joints in the body can be affected by a dislocation.
However, dislocations of the shoulder, elbow and knee joints are particularly common. Dislocated finger or jaw joints are also not uncommon. A dislocation is a serious injury to the affected joint and can lead to fractures, especially as it is growing.
causes
The causes of a dislocation are in most cases an indirect force of force on the affected joint. This could include a fall on the arm / shoulder.
In some sports, too, so-called hyperextension injuries can occur, which result in a dislocation of the finger joints, for example. Jerky and violent pulling on fingers, arms or legs can also cause a joint to be injured accordingly.
If a joint has already been affected by a dislocation several times, it may remain unstable compared to other joints - as a result, so-called habitual dislocations occasionally occur even without the use of force.
Symptoms, ailments & signs
A dislocation usually causes severe pain. The drifting apart of the bone ends can cause damage to the surrounding ligaments, vessels, nerves and muscles. As a result, the ability to move is usually greatly reduced, and a bruise often develops. As a result of the pain and the mechanical restriction, the patients hold the affected limb in a relieving position.
If nerve injuries occur in the course of the dislocation, abnormal sensations or paralysis can occur in other parts of the body. A tingling sensation in the fingers or numbness in the toes is possible, for example. The exact effects of the dislocation primarily depend 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 springing of the joint can be noticed. The outward signs are accompanied by reddening of the affected area and, occasionally, by visible deformations in the surrounding areas. A dislocation can also lead to bruises 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 & course
A dislocation can often be diagnosed by the attending physician based on the existing optical deformation of the affected joint. The joint head often protrudes clearly. There may be swelling and bruising.
A dislocation is usually accompanied by pain, which leads to a relieving posture. If the symptoms are ambiguous, an X-ray of the respective body region can help with the diagnosis.
If a dislocation is left untreated, permanent joint instability and the aforementioned habitual dislocations or even more frequent bone fractures in the area of the joints can occur. Osteoarthritis or permanent misalignment of the joint threatens as a long-term consequence.
Complications
First and foremost, a dislocation leads to relatively severe pain in the joints. The joints themselves are swollen and bruised. As a rule, 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 cannot be predicted. In many cases, the joint surfaces are in the wrong position after the dislocation, so that there are restrictions in the patient's movement and everyday life.
Usually, the diagnosis of the dislocation is relatively easy and quick because the joint is visibly protruding. Therefore an early treatment of this complaint is possible. However, there is no self-healing. If the dislocation is not treated properly, osteoarthritis can develop.
It is not uncommon for nerves to be trapped as a result of the dislocation, so that the patients suffer from paralysis or other sensory disorders and are thus restricted in everyday life. The treatment takes place by means of a surgical procedure and in most cases leads to success. There are no complications. The patient's life expectancy is also 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. Affected people should consult a doctor if symptoms appear acute and quickly worsen. If severe pain or even a fracture occurs as a result of a fall or a sports injury, the person must be taken to hospital. The affected part of the body must first be treated beforehand, ideally by a sports doctor or a first aider with appropriate first aid training. People with congenital weak connective tissue or overstretchable ligament structures suffer dislocations particularly quickly.
Also in old age and in connection with osteoarthritis or rheumatic diseases, there are more dislocations. The severe overstretching of ligaments and joints permanently weakens the joint, which is why caution is advised even after recovery. If a new dislocation is suspected, the family doctor must be informed immediately. In addition to the general practitioner, you can go to an orthopedic surgeon, chiropractor or sports doctor with a dislocation. Physiotherapeutic treatment is necessary for severe symptoms.
Treatment & Therapy
Does the attending physician have a dislocation diagnosed, he can initiate appropriate treatment. First and foremost, the misalignment of the joint-forming bones must be corrected.
Colloquially, this process is also referred to as "straightening". It should only be carried out by a specialist, as excessive force or a sudden incorrect movement can damage the joint itself or the surrounding nerves or vessels. Under certain circumstances, this not painless procedure has to be performed under anesthesia.
The affected joint should then be immobilized. An X-ray will tell you whether the reduction (straightening) was successful and whether there are any other injuries. If the joint cannot be returned to its original position as expected, surgery must be carried out to correct this. Surgery is often necessary even if the dislocation is accompanied by a broken bone.
Following a dislocation, the joint should not be excessively stressed for several weeks or even months. However, complete immobilization over a longer period of time is not advisable. If the injury occurred while exercising, it is often necessary to temporarily stop training in order to ensure complete restoration of joint stability. Corresponding physiotherapy exercises can support the healing process.
Outlook & forecast
In principle, the dislocation is easy to treat. Therefore, most patients get a favorable prognosis. With a well-established treatment plan and the cooperation of the person concerned, freedom from symptoms can usually be documented after a few months. It is important that medical treatment is used and that there is no excessive stress on the affected joint during the healing process.
Since the disorder is a dislocation of a joint, orthopedic and physiotherapeutic treatment should be used. Otherwise there is a risk of lifelong impairments and a restriction of the natural range of motion. Often there are secondary disorders that are discovered and cured during treatment. The prognosis for freedom from symptoms becomes less favorable if permanent damage to the joint has occurred or a dislocation has occurred repeatedly in the course of life. In these cases, changes in the organization of everyday or professional life have to take place, as the possibilities of movement are restricted and the physical performance can no longer be fully performed.
If a surgical procedure is carried out, it is associated with the usual risks and side effects. If complications arise during the operation or the healing process, the prognosis often deteriorates. In addition, the risk of secondary diseases increases, as an increase in emotional stress can be observed.
prevention
There one dislocation usually occurs as a result of acute violence, it is difficult to prevent. However, if certain joints are already known to be vulnerable, it is advisable not to put excessive strain on them. If a dislocation occurs, a doctor should be consulted immediately. This is the only way to ensure that the important joint stability can be fully restored after the traumatic injury.
Aftercare
A dislocation primarily leads to severe pain in the joints, which can sometimes persist even after the acute treatment. Therefore, aftercare is aimed at relieving this pain, which is sometimes first solved with medication. In addition, those affected should take it easy and avoid physical exertion as much as possible. The course of the disease cannot be predicted as the symptoms of a dislocation depend on the cause of it. So it can be that some are even more affected than others. Help and support from family members is needed in coping with everyday things. In most cases, the dislocation can be treated successfully. Life expectancy is not shortened by the dislocation.
You can do that yourself
Self-help measures in connection with a dislocation consist of protecting the affected joint and, if necessary, initiating pain relieving measures. It is advisable for those affected to follow the doctor's instructions and allow the joint to rest. In fact, if you have a dislocation, the best self-help measure is to rest the area for several weeks after re-adjusting.
In the event of an acute dislocation, it is not advisable to try to correct the position as a layperson. There are many ways of causing damage to the joint or the surrounding tissue. Exceptions here are repeatedly dislocated kneecaps: These can often be repositioned yourself after professional instruction.
Overall, any dislocation that occurs should be counteracted quickly by means of cooling, provided that pain and swelling occur. To avoid further swelling, an attempt should be made to elevate or hold the corresponding area. The coolant must not lie directly on the skin. Fixing the dislocated area with an auxiliary bandage or the like is also useful until medical examination and treatment. A chronic dislocation in joints cannot be corrected using self-help measures. Here can only be used to relieve pain.
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