Dislocations

By Hayden Newell

A dislocation occurs when extreme force is applied to a ligament, allowing the ends of two connected bones to separate. Ligament’s are strong, fibrous cords that attach one bone to another. They provide the stability of a joint, especially during movement.

Dislocations of joints can occur in any situation, whether it being the sporting arena or routine daily chores.

Adults are more prone to suffering a dislocation than a child, due to the fact that children’s growth plates are weaker than the muscles or tendons that surround the joint.

Once a joint dislocates it will always be weaker andprone to further dislocations. This is due to the surrounding ligaments and muscles being weakenedby the trauma. On occasions the dislocated site even after being repaired may look deformed.

SIGNS:– Swelling

– Deformity

– Warmth, Bruising or Redness

– Tenderness

SYMPTOMS:– Severe Pain

– Difficulty Using or Moving

– Loss of Sensation

– Weakness

Signs and symptoms would assist with early diagnosis and assist in immediate first aid, however correct diagnosing would require medical examination and utilize the following:

- x-ray - a diagnostic test which uses invisible electromagnetic energy beams to produce images of internal tissues, bones, and organs onto film.

- magnetic resonance imaging (MRI) - a diagnostic procedure that uses a combination of large magnets, radiofrequencies, and a computer to produce more detailed and precise images of structures within the body than an x-ray can depict, allowing correct diagnosis and appropriate treatment.

The main focus of the first aid management is to immobilise the dislocated joint in the position found. The victim needs to be comforted and reassured. Ambulance transport should be arranged if required.

The first aider needs to be aware that, with a dislocation, there is a strong possibility that a fracture could also have occurred.

Initial treatment of a dislocation includes rest, ice and elevation. Dislocations may reduce spontaneously, meaning the bone ends may go back into place by themselves. However, for those dislocations

that do not go back into place, a medical practitioner will need to place the joint back into its proper position so it will heal. Sedation will also help the muscles around the dislocated joint relax, so the joint can be put back into place more easily.

Your medical practitioner may recommend any of the following to help reduce the dislocation or promote healing afterwards:

– Splint/cast - immobilizes the dislocated area to promote alignment and healing; protects the injured area from motion or use.

– Medication (for pain control).

– Traction - the application of a force to stretch certain parts of the body in a specific direction. Traction consists or pulleys, strings, weights, and a metal frame attached over or on the bed. The purpose of traction is to stretch the muscles and tendons around the bone ends to help reduce the dislocation.

– Surgery (especially for reoccurring dislocations or if a muscle, tendon, or ligament is badly torn).

S – stop: the patient from moving or any dangers.

T – talk: if the patient is conscious ask them questions.

O – observe: closely what the patient is actually saying. See if the injured site is swollen, deformed or bleeding.

P – prevent: further injury to the patient by conducting a whole body assessment.

R – rest: sit or lie the patient down in a comfortable position.R – rest: sit or lie the patient down in a comfortable position.

I – ice: use ice or cold packs to cool the affected area.I – ice: use ice or cold packs to cool the affected area.

C – compression: wrap a compression bandaged around the limb, to C – compression: wrap a compression bandaged around the limb, to support it and restrict movement.support it and restrict movement.

E – elevate: the injured limb should be supported so it is above the E – elevate: the injured limb should be supported so it is above the level of the heart.level of the heart.

R – referral: refer the patient to either a doctor or hospital if required.R – referral: refer the patient to either a doctor or hospital if required.

D – danger: make sure there is no danger to yourself, bystanders or the patient.

R – response: from the patient. Attempt to ascertain if the patient is conscious. (by verbal or physical means)

A – airway: ensure airway is clear if patient is unconscious.

B – breathing: listen and feel for the signs of life.

C – compression: (if patient is unconscious) commence cardiopulmonary resuscitation. (CPR)

D – defibrillation: if certified defibrillation should be administered as soon as possible.

• http://www.csmfoundation.org/Knee_Dislocation_-_Clippers.jpg

• http://builttour.typepad.com/mountainkhakis/images/utah_018.jpg

• http://www.whoateallthepies.tv/davies%20dislocated%20finger.jpg

• http://www.healthsystem.virginia.edu/uvahealth/peds_orthopaedics/dislocat.cfm

• http://www.chw.org/display/PPF/DocID/22592/router.asp

• http://www.richardwardracing.co.uk/2004/shoulder.jpg

• http://www.athleticadvisor.com/Injuries/UE/Shoulder/disloc5.jpg

• http://www.medscape.com/content/1998/00/40/84/408480/art-mos3052a.fig2.jpg

• http://emcrit.org/images/news041403gg.jpg

• 2 Unit Personal Development, Health and Physical Education, Core 3: The Body in Motion