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dislocation(dis?lo-ka'shon) [ ¹dis- + location]
anterior hip dislocation
Pain, tenderness, and immobility accompany the dislocation. Shortening is present in the pubic and suprapubic forms, lengthening in the obturator and perineal forms.
Hyperextension and direct traction are used to treat this condition, followed by flexion, abduction with inward rotations, and adduction.
dislocation of clavicle
Open or closed reduction is the treatment.
congenital dislocation of the hip
developmental dislocation of the hipAbbreviation: DDH
Congenital dislocation of the hip.
dislocation of finger
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.
dislocation of the hip
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.
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.
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.
inferior hip dislocation
dislocation of jaw
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.
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
Lisfranc dislocationSee: Lisfranc dislocation
mandibular dislocationSee: subluxation
metacarpophalangeal joint dislocation
Monteggia dislocationSee: Monteggia dislocation
open dislocationCompound dislocation.
partial dislocationIncomplete dislocation.
posterior hip dislocation
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.
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.
dislocation of shoulder
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.
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.
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.
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.