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  • Joint Dislocation

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    Nurulasyikin MAA
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    Joint dislocation involves the displacement of a bone from its normal position in a joint. While considered an orthopedic emergency, emergency doctors often initially treat common dislocations like those of the shoulder, knee, hip, and elbow. Reduction, or putting the bone back in place, may require sedation and is sometimes followed by orthopedic management if there are complications like fractures. The emergency doctor's goals are airway protection, analgesia administration, and preparation for possible closed manual reduction of the dislocation.

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    Joint dislocation involves the displacement of a bone from its normal position in a joint. While considered an orthopedic emergency, emergency doctors often initially treat common dislocations like those of the shoulder, knee, hip, and elbow. Reduction, or putting the bone back in place, may require sedation and is sometimes followed by orthopedic management if there are complications like fractures. The emergency doctor's goals are airway protection, analgesia administration, and preparation for possible closed manual reduction of the dislocation.

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    © All Rights Reserved
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    21 views2 pages

    Joint Dislocation

    Uploaded by

    Nurulasyikin MAA
    Joint dislocation involves the displacement of a bone from its normal position in a joint. While considered an orthopedic emergency, emergency doctors often initially treat common dislocations like those of the shoulder, knee, hip, and elbow. Reduction, or putting the bone back in place, may require sedation and is sometimes followed by orthopedic management if there are complications like fractures. The emergency doctor's goals are airway protection, analgesia administration, and preparation for possible closed manual reduction of the dislocation.

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    © All Rights Reserved
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    JOINT DISLOCATION

    ● Joint dislocation is part of orthopaedic emergencies which have to be diagnosed and


    treated early.
    ● Although it is termed orthopedic emergency, management of these dislocations are done
    by emergency doctors most of the time.
    ● In cases where the dislocation is complicated with fracture(s), it is then managed by the
    orthopaedic team.

    Common dislocation seen in emergency department:

    Common Mechanism Clinical features X-Ray example Complications


    dislocation of injury

    Anterior Occur with ● Severe ● Fractures


    shoulder abduction, shoulder pain ● Rotator cuff
    dislocation extension ● Unable to injury
    and external move shoulder ● Axillary nerve
    rotation ● Empty glenoid injury
    fossa ● Vascular injury
    ● Arm in in
    external
    rotation and
    slight
    abduction
    ● Humeral head
    can be
    palpated at
    anterior
    shoulder
    (below
    coracoid
    process)

    Anterior
    knee
    dislocation

    Posterior
    hip
    dislocation

    Posterior
    elbow
    dislocation
    Posterior
    ankle
    dislocation

    Management of joint dislocation:


    1. Triage to yellow zone
    2. Ensure patency of airway and breathing
    3. Insert large bore branula and start IVD normal saline maintenance
    4. Give analgesia
    5. Prepare sedation
    6. For closed manual reduction (CMR) under procedural sedation and analgesia (PSA).

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