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An traumatic dislocation of the tibiotalar joint of the ankle with distal fibular fracture. Open arrow marks the tibia and the closed arrow marks the talus.
Joint dislocation, or luxation (Latin: luxatio) , occurs when bones in a joint become displaced or misaligned. It is often caused by a sudden impact to the joint. The ligaments always become damaged as a result of a dislocation. A subluxation is a partial dislocation.
A dislocated joint usually can only be successfully 'reduced' into its normal position by a trained medical professional. Trying to reduce a joint without any training could result in making the injury substantially worse.
X-rays are usually taken to confirm a diagnosis and detect any fractures which may also have occurred at the time of dislocation. A dislocation is easily seen on an X-ray.
Once a diagnosis is confirmed, the joint is usually manipulated back into position. This can be a very painful process, therefore this is typically done either in A&E under sedation or in an Operating Room under a general anaesthetic.
It is important the joint is reduced as soon as possible, as in the state of dislocation, the blood supply to the joint (or distal anatomy) may be compromised. This is especially true in the case of a dislocated ankle, due to the anatomy of the blood supply to the foot.
Shoulder injuries can also be surgically stabilized, depending on the severity, using arthroscopic surgery.
Some joints are more at risk of becoming dislocated again after an initial injury. This is due to the weakening of the muscles and ligaments which hold the joint in place. The shoulder is a prime example of this. Any shoulder dislocation should be followed up with thorough physiotherapy.
After a dislocation, injured joints are usually held in place by a splint (for straight joints like fingers and toes) or a bandage (for complex joints like shoulders). Additionally, the joint muscles, tendons and ligaments must also be strengthened. This is usually done through a course of physiotherapy, which will also help reduce the chances of repeated dislocations of the same joint.
Although it is possible for any joint to become subluxed or dislocated, the most common sites it is seen in the human body are:
- Shoulders (see Dislocated shoulder),
- Wrists (most likely be accompanied by a fracture)
- Elbows (if ulnar most likely accompanied by a fracture, if radial most likely not accompanied by a fracture)
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