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Joint Dislocation

It is complete and persistent displacement of a joint in which at least part of the supporting joint capsule and some of its ligaments are disrupted.

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amri
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37 views

Joint Dislocation

It is complete and persistent displacement of a joint in which at least part of the supporting joint capsule and some of its ligaments are disrupted.

Uploaded by

amri
Copyright
© © All Rights Reserved
Available Formats
Download as PPTX, PDF, TXT or read online on Scribd
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Joint Dislocation

Definition
 It is complete and persistent displacement of a
joint in which at least part of the supporting
joint capsule and some of its ligaments are
disrupted.
Types of dislocation
 Congenital
 Acquired
1. Traumatic
2. Pathological e.g. TB hip, Septic Arthritis
3. Paralytic e.g. Poliomyelitis, cerebral palsy, etc
4. Inflammatory disorders, rheumatoid
arthritis,etc
Dislocation
 No joint is immune from dislocation
 Most commonly occur in the following joints.
 Shoulder
 Hip

 Elbow

 Metacarpophalengeal joint

 Facet joint dislocation in cervical spine.

 Acromiclavicular joint dislocation.


Typical deformities in
dislocation
 Shoulder- abduction deformities
 Elbow- flexion deformities
 Hip:
 Anterior- flexion abduction
and internal rotation
deformities.
 Posterior-flexion, adduction and
internal rotation deformity
 Knee-flexion deformity
 Ankle-varus deformity
Investigations
 Radiograph of the affected part should
include anterior posterior and lateral views
and sometimes special views needed.
 CT Scan
Principles of management
 Acute dislocation should be reduced as soon as
possible.
 Open reduction is rarely necessary for acute
dislocation.
 Close reduction with intravenous analgesia and
sedation or under GA should be attempted first
for most uncomplicated dislocation.
Complication
1. Acute: Injury to peripheral nerve and vessels
2. Chronic: Unreduced dislocation
Recurrent dislocation
Traumatic osteoarthritis
Joint stiffness
Avascular necrosis
Myositis ossificans
Caution !
 Excessive force should not be used in close
reduction.
 Forceful manipulation may lead to fracture.

 Interposition of soft tissue, bony fragment or


buttonhole in capsule may make close reduction
impossible.
Remember in Dislocation
 It is an orthopedic emergency.
 Reduction should be quick and prompt.
 Reduction should always be under G/A or
sedation.
 Swelling is less in compared to fractures.
 Movements are more restricted than in fractures.
Remember in Dislocation
 Closed reduction is sufficient in most of
the times.
 Open reduction is restored to if
specifically indicated.
 Reduction techniques should always be very
gentle.
 Pain will not subside by splinting unlike
fractures.
Shoulder Dislocation
 Types:
 Anterior dislocation: Varities of dislocations
like Subcoracoid, subglenoid, sub-
infraclavicular, inferior.
 Posterior Dislocation
Radiological Images
Anterior Dislocation
Radiological Images
Anterior dislocation

 Occurs with the arm


held in abduction and
external rotation.
Radiological Images
Posterior Dislocation

 Causes
1. Epilepsy
2. Electrocution
Reduction Techniques

 Stimson’s Gravity Method


Reduction Techniques

KOCHER’s Method
Reduction Techniques
After Treatment

 The arm should be fasten to the chest with a


body bandage minimum period of three
weeks.
Hip Dislocation

Types:
A. Posterior Dislocation

B. Anterior Dislocation

C. Center Dislocation
Mechanism of Dislocation
Hip Dislocation
 Clinical Features:
o H/O Trauma
o The patient has a flexion,
adduction and medial
rotational deformity of
the affected limb.
o Hip movement grossly
restricted.
Radiological Images
Hip dislocation
Hip Dislocation
Reduction techniques
 The patient is supine on
the floor under GA.
 The hip is flexed to 90
degree.
 Assistant stabilizing the
pelvis.
 Longitudinal traction is
applied.
Hip Dislocation
After Treatment
 The patient is put on surface traction for three
weeks.
 Full weight bearing is permitted after 6 wks.
Elbow Dislocation

 Commonly due to fall on


outstretched hand.
 Closed reduction and long
arm back slab for 3 wks is
the treatment of choice.
MP Joint Dislocation
IP Dislocation

 Reduction Techniques
Facet joint Dislocation
 Commonest cervical
spinal injury.
 May lead to
quadriplegia.
 May be treated
conservatively by
Traction.
 May also need Open
Reduction
Thank you

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