TRAUMATIC JOINT DISLOCATION

• Ms.Akshata vijay Bansode

• Clinical instructor
• K.B.N.C
A dislocation is an injury to a joint. It occurs when the surfaces of the
bones forming the joint are dislocated from its anatomic contact. It is
most common in shoulders and fingers. Other sites include elbows,
knees and hips. It is a medical emergency because of associated
disruption of surrounding blood and nerve supplies
Etiology
• 1. Dislocation may be congenital

• 2. Spontaneous or pathologic dislocation might be associated with

some disease.
• 3. Traumatic, i.e. resulting from injury in which joint is disrupted by
force.
Dislocations can occur in contact sports, such as football and hockey,
and in sports in which falls are common such as downhill skiing,
gymnastics and volleyball.
Basketball players and football players also commonly dislocate joints in
their fingers and hands by accidentally striking the ball, the ground or
another player.
A hard blow to a joint during a motor vehicle accident and landing on
an outstretched arm during a fall are other common causes
Risk Factors
1. Susceptibility to falls: Falling increases the chance of a dislocated
joint, if a person use his/her arms to brace for impact or if a person
land forcefully on his/ her body part, such as hip or shoulder
2. Heredity: Some people are born with ligaments that are looser and
more prone to injury than those of other people.
3. Sports participation: Many dislocations occur during high-impact or
contact sports, such as gymnastics, wrestling, basketball and football.
4. Motor vehicle accidents: These are the most common cause of hip
dislocations, especially for people not wearing a seat belt.
Clinical Manifestations
1. Intense pain.
2. Deformity: Visibly deformed or out of place.
3. Change in the length of the extremity.
4. Loss of normal movement.
Diagnostic Evaluation
1. Patient history and physical examination.
2. X-ray confirms dislocation without associated fracture.
Management
1. Immobilization:
a. Immobilize the affected part.
b. Bring displaced parts into normal position as soon as possible.
c. Stabilize reduction until joint structures are healed to prevent
permanently unstable joint or aseptic necrosis of bone.
d. Bandages, splint, plaster casts or traction is maintained.
2. Medication: Analgesics, muscle relaxants and anesthesia are used
during closed reduction.
3. Neurovascular status: Neurovascular status is monitored
4. Exercises: Active and passive exercises can be started gradually. Joint
should be supported during exercise.
Nursing Management
1. Assess for muscle weakness and severity of the weakness
2. Provide assistive devices, e.g. braces, splints, wheel chair to
increase mobility.
3. Range of motion exercise and other physical therapy prevent
contractures and improve muscle strength.
4. 4. Encourage the patient to do activity as much as possible as it
increases independence and helps to maintain muscle function.
5. Respiratory rate and effort should be monitored every 4 hourly.
6. Measures to prevent skin breakdown must be taken.
7. Assess neurovascular status of the extremity before and after
reduction of dislocation.
8. By teaching, ensure proper use of immobilization device after
reduction.
9. Review instructions for activity restrictions and need for
physiotherapy and follow-up.
10. Promote healing during immobilization and prevent further injury.
11. Administer prescribed medicine.
Complications
1. Tearing of the muscles, ligaments and tendons.
2. Nerve or blood vessel damage in or around joint.
3. Susceptibility to reinjury or repeated dislocations