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Dislocation

Joint dislocation

A dislocation is a separation of two bones where they meet at a joint. A joint is the place where two bones connect, which allows movement.

A dislocated joint is a joint where the bones are no longer in their normal positions.

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Radial head injury
Dislocation of the hip
Shoulder joint

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Considerations

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:

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 orthopedic surgeon (a bone and joint doctor).

Causes

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

Symptoms

A dislocated joint may be:

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

First aid steps to take:

  1. Call 911 or the local emergency number 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. Do not attempt to put the bone back in place unless you are a bone specialist.
  5. Apply a splint or sling to 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 (30 centimeters), and cover the person with a coat or blanket.

Do Not

When to Contact a Medical Professional

Call 911 or the local emergency number right away if the person has any of the following:

Prevention

To help prevent injuries in children:

To help prevent dislocations in adults:

For all age groups:

Related Information

Broken bone
Osteonecrosis

References

Klimke A, Furin M, Overberger R. Prehospital immobilization. In: Roberts JR, Custalow CB, Thomsen TW, eds. Roberts and Hedges' Clinical Procedures in Emergency Medicine and Acute Care. 7th ed. Philadelphia, PA: Elsevier; 2019:chap 46.

Mascioli AA. Acute dislocations. In: Azar FM, Beaty JH, Canale ST, eds. Campbell's Operative Orthopaedics. 13th ed. Philadelphia, PA: Elsevier; 2017:chap 60.

Naples RM, Ufberg JW. Management of common dislocations. In: Roberts JR, Custalow CB, Thomsen TW, eds. Roberts and Hedges' Clinical Procedures in Emergency Medicine and Acute Care. 7th ed. Philadelphia, PA: Elsevier; 2019:chap 49.

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Review Date: 7/8/2020  

Reviewed By: C. Benjamin Ma, MD, Professor, Chief, Sports Medicine and Shoulder Service, UCSF Department of Orthopaedic Surgery, San Francisco, CA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

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