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Joint Dislocation

Joint Dislocation

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Published by LoveShery

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Categories:Types, School Work
Published by: LoveShery on Oct 17, 2010
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10/17/2010

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JOINT DISLOCATION
y
 
Joint dislocation
, or
luxation
, occurs when bones in a joint become displaced ormisaligned. It is often caused by a sudden impact to the joint. The ligaments alwaysbecome damaged as a result of a dislocation.
y
 
A
dislocation of a joint is a condition in which the articular surfaces of the bones formingthe joint are no longer in anatomic contact. The bones are literally out of joint.
y
 
A
 
subluxation
is a partial dislocation of the articulating surfaces.
y
 
Traumatic dislocations are orthopedic emergencies because the associated jointstructures, blood supply, and nerves are distorted and severely stressed. If thedislocation is not treated promptly,
avascular necrosis
(tissue death due to anoxia anddiminished blood supply) and nerve palsy may occur.
y
 
D
islocations may be congenital, or present at birth (most often the hip); spontaneous orpathologic, caused by disease of the articular or periarticular structures; or traumatic,resulting from injury in which the joint is disrupted by force.
SYMPTOMS
y
 
S
welling
 
y
 
Immobility of the affected joint
y
 
A
ccompanied by numbness or tingling at the joint or beyond it
y
 
Intensely painful, especially if you try to use the joint or bear weight on it
y
 
L
imited in movement
y
 
S
wollen or bruised
y
 
V
isibly out of place, discolored, or misshapenNursemaid's elbow is a partial dislocation common in toddlers. The main symptom is refusal touse the arm.
Nursemaid's Elbow
is a dislocation of the elbow. It usually occurs in children younger than 5years old. It often occurs when an adult or another child pulls or jerks a child's arm.
S
ymptomsof nursemaid's elbow are: pain and limited mobility in the elbow. When the bones are returnedto their normal place, the pain decreases.
CAUSES
 
y
 
The most common causes are a blow, fall, or other trauma to the joint. In some cases,dislocations are caused by a disease or a defective ligament. Rheumatoid arthritis canalso cause joint dislocation.
 
TREATMENT
 
Medical Management
y
 
The affected joint needs to be immobilized while the patient is transported to thehospital. The dislocation is promptly reduced (displaced parts are brought into normalposition) to preserve joint function.
y
 
A
nalgesia, muscle relaxants, and possibly anesthesia are used to facilitate closedreduction.
y
 
The joint is immobilized by bandages, splints, casts, or traction and is maintained in astable position.
y
 
Neurovascular status is monitored.
y
 
A
fter reduction, if the joint is stable, gentle, progressive, active and passive movement isbegun to preserve range of motion (ROM) and restore strength. The joint is supportedbetween exercise sessions.
y
 
A
dditionally, the joint muscles, tendons and ligaments must also be strengthened. Thisis usually done through a course of 
physiotherapy
, which will also help reduce thechances of repeated dislocations of the same joint.
Nursing Management
y
 
Nursing care is directed at providing comfort, evaluating the patients neurovascularstatus, and protecting the joint during healing.
y
 
The nurse teaches the patient how to manage the immobilizing.X-rays confirm the diagnosis and demonstrate any associated fracture.

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