partial dislocation


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partial dislocation

Etymology: L, pars + dis + locare, to place
the partial, abnormal separation of the articular surfaces of a joint. Also called incomplete dislocation, subluxation.

dislocation

(dis?lo-ka'shon) [ ¹dis- + location]
The displacement of any part, esp. the temporary displacement of a bone from its normal position in a joint.

ankle dislocation

Traumatic displacement of the talocrural joint with or without concurrent fracture of the tibial or fibular malleoli, or both.

anterior hip dislocation

A dislocation of the hip through the obturator foramen, on the pubis, in the perineum, or through a fractured acetabulum.

Symptoms

Pain, tenderness, and immobility accompany the dislocation. Shortening is present in the pubic and suprapubic forms, lengthening in the obturator and perineal forms.

Treatment

Hyperextension and direct traction are used to treat this condition, followed by flexion, abduction with inward rotations, and adduction.

closed dislocation

A dislocation in which the skin overlying the joint remains intact.
Synonym: simple dislocation

complete dislocation

A dislocation that separates the surfaces of a joint completely.

complicated dislocation

A dislocation associated with other major injuries.

compound dislocation

A dislocation in which separation of the joint causes disruption of the overlying skin.
Synonym: open dislocation

condylar dislocation

In the jaw, a dislocation of the mandibular condyle in front of the condylar eminence. It is often caused by keeping the mouth wide open for an extended time, as in dental treatment that involves a rubber dam. See: subluxation

dislocation of clavicle

Traumatic displacement of the clavicle at either the sternoclavicular or the acromioclavicular joint.

Treatment

Open or closed reduction is the treatment.

congenital dislocation

A dislocation existing from or before birth.

congenital dislocation of the hip

A congenital defect of the hip joint, probably caused by multifactorial effects of several abnormal genes.
Synonym: developmental dislocation of the hip; developmental dysplasia of the hip

consecutive dislocation

A dislocation in which the luxated bone has changed position since its first displacement.

developmental dislocation of the hip

Abbreviation: DDH
Congenital dislocation of the hip.

divergent dislocation

A dislocation in which the ulna and radius are displaced separately. It also may involve the tibia and fibula.

dislocation of finger

Displacement of a finger bone. This occurs only at a joint. If there has been a crushing injury, it should be treated as a fracture until radiography has been performed. Dislocations of a finger usually are easily diagnosed. They may be caused by blows, falls, and similar accidents.

First, it is important to ascertain that there is no fracture. Then the patient should be asked to steady and support the wrist (or have somebody else do so) for countertraction. The finger is grasped beyond the dislocated muscles and tendons and, with the free hand, the dislocated bone is slipped into place. A splint is applied from the tip of the finger well into the palm of the hand. The splint may be made of plastic, of tongue depressors, or temporarily of heavy cardboard.

CAUTION!

No attempt should be made to reduce a dislocation of any finger joint until radiography has ruled out the possibility of fracture.

fracture dislocation

A fracture near a dislocated joint.

habitual dislocation

Recurrent joint dislocation resulting during normal motion. The patella and the hip are the most commonly affected joints.

dislocation of the hip

A dislocation of the head of the femur from its normal location in the acetabulum. It is very often accompanied by a fracture.

Symptoms

The dislocation is characterized by pain, rigidity, and loss of function. The dislocation may be obvious by the abnormal position in which the leg is held, seen, or felt.

Diagnosis

The person has great difficulty in straightening the hip and leg. The knee on the injured side resists being pointed inward toward the other knee and typically appears in a position of flexion, adduction, and internal rotation.

First Aid

The patient should be placed on a large frame, gurney, or support, such as that used for a fractured back. A large pad or pillow should be placed under the knee of the affected side. The patient should be treated for shock if required.

incomplete dislocation

A slight displacement of opposing surfaces. Synonym: partial dislocation See: subluxation (1)

inferior hip dislocation

A rare type of hip dislocation in which the femoral head is displaced below the acetabulum. Inferior hip dislocations are treated with traction in the flexed position, followed by external rotation and extension.

dislocation of jaw

Traumatic or spontaneous displacement of the mandible. Jaw dislocations are uncomfortable and may be psychologically distressing. They may occur on either side, in which instance the tip of the jaw is pointed away from the dislocation. On the unaffected side, just in front of the ear, may be felt a little hollow or depression that is often tender. If both sides of the jaw are dislocated, the jaw is pushed downward and backward. In either event, there is pain and difficulty in speech and the condition is often accompanied by shock. Backward dislocation of the jaw is rare.

Causes

Jaw dislocation is usually caused by a blow to the face or by keeping the mouth open for long periods as in dental treatment, but occasionally may be caused by chewing large chunks of food, yawning, or hearty laughing. A fall or blow on the chin could cause dislocation, but backward dislocation seldom occurs without fracture or extreme trauma.

Reduction

These dislocations are reduced by placing well-padded thumbs inside of the mouth on the lower molar (back) teeth with the fingers running along the outside of the jaw as a lever. The thumbs should press the jaw downward and backward. The jaw will glide posteriorly over the ridge of bone (articular eminence), which can be felt, and just as this occurs the jaw usually snaps into place. When this motion is noted, the thumbs should be moved laterally toward the cheeks to keep them from being crushed between the molars.

This snapping into place is due to an involuntary spasm of the muscles, which pulls the jaw as though an overstretched rubber band were attached to it. Following the reduction, an immobilizing bandage or double cravat should be applied.

CAUTION!

It is important that the hands be protected by heavy gloves to prevent trauma by the teeth.

dislocation of knee

Displacement of the knee (tibiofemoral joint), an uncommon injury, universally complicated by tearing of the cruciate ligaments, and often associated with peroneal nerve or popliteal artery damage. In a knee dislocation at least three of the four major ligaments, anterior cruciate, posterior cruciate, medical collateral, lateral collateral, are torn. Dislocations should be reduced by an orthopedic surgeon as soon as is feasible to preserve circulation to the lower extremity.

Lisfranc dislocation

See: Lisfranc dislocation

mandibular dislocation

See: subluxation

metacarpophalangeal joint dislocation

A dislocation of the joint between the carpals and the phalanges, usually involving the index finger or small finger of the hand. The dislocation may be simple and respond to closed manipulation or be complex and require surgery.

Monteggia dislocation

See: Monteggia dislocation

old dislocation

A dislocation in which no reduction has been accomplished even after many days, weeks, or months.

open dislocation

Compound dislocation.

partial dislocation

Incomplete dislocation.

pathological dislocation

A dislocation resulting from paralysis or disease of the joint or supporting tissues.

posterior hip dislocation

A dislocation of the hip onto the dorsum ilii or sciatic notch. Most such dislocations occur when the hip is flexed and adducted and a violent longitudinal force is applied to the femur that forces the femoral head posterior relative to the acetabulum. This dislocation is often seen in automobile accidents.

Symptoms

The condition is characterized by an inward rotation of the thigh, with flexion, inversion, adduction, and shortening; pain and tenderness; and a loss of function and immobility.

Treatment

The patient should first be anesthetized and then laid on his back with the leg flexed on the thigh and the thigh on the abdomen. The thigh is adducted and rotated outward. Circumduction is performed outwardly across the abdomen and then back to the straight position. Traction may be required.

primitive dislocation

A dislocation in which the bones remain as originally displaced.

recent dislocation

A dislocation seen shortly after it occurred.

dislocation of shoulder

Displacement of the head of the humerus beyond the boundaries of the glenoid fossa. See: Bankart lesion; Hill-Sachs lesion

Etiology

The most common cause is from trauma with the arm in external rotation with abduction, causing the head of the humerus to sublux anteriorly; a posterior subluxation may occur from a fall on an outstretched arm. An inferior dislocation may occur from poor muscle tone as with hemiplegia and from the weight of the arm pulling the humerus downward. Anterior glenohumeral dislocations are common among athletes, esp. football players.

Signs

A patient with a dislocated shoulder usually has a hollow in place of the normal bulge of the shoulder, as well as a slight depression at the outer end of the clavicle. Glenohumeral range of motion is restricted and such patients often cannot touch their opposite shoulder with the hand of the involved arm. Both shoulders should always be compared for symmetry. Vital signs are assessed to provide baseline data. The patient is assessed for pain, and analgesia prescribed and provided as needed.

Treatment/First Aid

Radiographs and/or MRI are needed to determine the type of dislocation and the presence of any fracture. If no fractures are present, one of several maneuvers can be used to reduce the humerus into the glenoid.

Patient care

Because of the potential damage to neurovascular structures as they cross the glenohumeral joint line, the vascular and neurological status of the arm and hand must be assessed. A decreased or diminished ulnar or radial pulse warrants immediate intervention and reduction of the dislocation. An anterior dislocation of the shoulder can be reduced, for example, with passive traction on the arm or by placing the patient in a supine position and medially displacing the scapula. A sling or other shoulder support is provided after reduction to limit shoulder mobility for the prescribed time, and activity is gradually resumed using a guided rehabilitation protocol.

simple dislocation

Closed dislocation

slipped dislocation

See: herniated intervertebral disk

subastragalar dislocation

Separation of the calcaneum and the scaphoid from the talus.

subspinous dislocation

A dislocation with the head of the humerus resting below the spine of the scapula and medial to the acromion process.

dislocation of the toe

Traumatic displacement of bones of a toe. This condition is treated essentially the same as dislocation of the finger.
See: dislocation of finger

traumatic dislocation

A dislocation due to injury or violence.

subluxation

partial joint dislocation; articular surfaces remain in partial contact, but with some loss of normal joint relationship (contrast with dislocation)
References in periodicals archive ?
Meanwhile, Sri Lanka coach Dav Whatmore defended the decision to play off-spinner Muttiah Muralitharan despite him not being able to bat or field properly because of his sore left shoulder, which is still recovering from partial dislocation and tendon damage.
Under the new law, members being forced to move out of government quarters at the government's convenience, not their own will, receive a partial dislocation allowance of $500.
A partial dislocation where the upper arm bone is partially in and partially out of the socket is called a subluxation.
We believe the recent wave of enterprise vendor consolidation has created a partial dislocation of the technology market and an opportunity for RCM to offer innovative bundled solutions.
Tailback Curtis McNeal said X-rays revealed a bruised shoulder, but there was no partial dislocation as originally diagnosed.
Jones is understood to be okay following his injury, but winger Tom James suffered a partial dislocation of his shoulder in last night's match and will undergo a scan.
PFD describes a number of painful conditions related to the patella, including partial dislocation, abnormal alignment, patellar tendonitis and osteoarthritis.
I suffered a partial dislocation against the Barbarians and was warned that another bang on the shoulder could bring a full dislocation and with it a ninemonth layoff,'' said Harris.

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