Dislocations: what are they?

By Cristiano Antonino On May 30, 2023

What are dislocations? The bones that make up the human skeleton are bound together by joints that, according to their degree of mobility, are classified into fixed joints, mobile joints and semi-mobile joints

Mobile joints – in order to have the mobility with which they are endowed – are surrounded and supported by a system of ligaments and the joint capsule, as well as by tendons and muscles.

Following a traumatic event – this system that binds the two joint heads together – partially or completely collapses.

The slippage between the two joint heads is called a luxation

The medical term ‘dislocation’ – from the Latin ‘luxus’ = ‘gone out of place’, ‘dislocated’ – in fact indicates a condition that occurs when, within a joint, the joint heads leave their usual seat, their physiological position without, however, there being any bone fracture.

A luxation can be either complete or incomplete

A complete dislocation occurs when the surfaces of the injured joint heads move out of their seat to such an extent that they can no longer touch each other; an incomplete dislocation or subluxation occurs when some contact remains between the joint surfaces affected by the traumatic event.

In both cases, the dislocated joint surfaces require external intervention to return to their seat.

The most frequent dislocations

Among the most frequent cases of dislocation are shoulder dislocations, elbow dislocations, hip dislocations, finger dislocations and patella dislocations.

This is due to the effective lack of support that these joints – the most mobile of all – have from the muscular system, which must allow the joint as much movement as possible to enable normal motor activities.

Greater freedom of movement is therefore unfortunately associated with a greater possibility of incurring injuries such as dislocation.

The causes of a dislocation

Depending on the triggering event, dislocations can be divided into traumatic, congenital and pathological.

Traumatic dislocations

As the term ‘traumatic’ itself suggests, all dislocations occurring due to trauma belong to this group.

The trauma can generally occur during the practice of a sport – football, basketball, rugby, volleyball, skiing and gymnastics in general – or as a result of an accident – falls on a bicycle, motorbike or following motor vehicle accidents -.

Within dislocations of a traumatic type, it is possible to recognise a further subdivision into recent dislocations and recurrent dislocations that recur as a result of increasingly mild trauma.

Congenital dislocations

Congenital dislocations are usually caused by malformations – congenital, in fact – of the joint heads; malformations that children manifest at birth or in infancy.

Among the most common congenital luxations is hip luxation.

Pathological or degenerative dislocations

Pathological dislocations are the effects of other pathologies, the symptoms of which include altered joint relationships.

Dislocation: symptoms

A dislocated joint is generally characterised by the following symptomatology:

Visible deformity of the joint involved
inability to perform the normal movement of the joint
visible swelling
Warmth to the touch
Sudden intense pain, intensified on palpation
Abrasion or skin with obvious bruising

Diagnosis of a dislocation

Diagnosing a dislocation is, in fact, fairly straightforward for any general practitioner; it is even easier for the relevant specialist: the orthopaedist.

The ease of diagnosis is due to the fact that the damage caused by dislocation to the joint is quite evident even to the naked eye.

In any case, it will be necessary to initiate a series of tests in order to have as complete an overview as possible of the clinical picture of the patient with a dislocated joint.

X-rays and MRI scans will then be requested in order to be able to highlight the possible presence of complications, such as bone fractures, nerve injuries, and blood vessel injuries.

Dislocations: appropriate treatment and rehabilitation

Following the event that has led to dislocation of a joint, it is a good idea to intervene as soon as possible; in any case, never later than 24/48 hours.

Waiting too long to seek medical advice could complicate the patient’s clinical picture in no small measure.

Not long after the dislocation, the healing process of the lesion begins biologically, which could lead to improper healing, compromising the motor and articular capacities of the dislocated joint much more seriously.

The doctor who must be consulted in such cases is the orthopaedist, who will be able to put the dislocated joint head back in its appropriate place without further compromising the surrounding tissues.

The manoeuvre of reinserting the joint head may be quite painful, which is why it can only take place after the patient has been given a sufficient dose of anaesthetic.

Once the dislocation has been reduced, rehabilitation will restore the patient to pre-traumatic fitness.

Depending on the magnitude of the injury, an initial period of absolute rest may follow in the case of severe injuries; or, in the case of milder injuries, early mobilisation of the joint may be opted for immediately.

It is possible that early mobilisation may be accompanied, during the rehabilitation activity, by rather intense pain which, in order to be kept under control, requires the administration of oral or infiltration painkillers.

This is followed by the rehabilitation period proper, in order for the patient to regain lost mobility by working on strengthening muscle tone.

This is done through a series of targeted exercises to enable the muscles to adequately support and hold the still-healing joint.

Dislocations: can they be prevented?

Although most dislocations are caused by an absolutely unpredictable event – such as trauma – there is a way to prevent dislocation, or at least try to prevent it: it is called ‘muscle strengthening’.

With constant physical activity aimed at strengthening, the muscular apparatus will optimally support the skeleton, adequately accompanying all joints in their movements, even the most bumpy and unpredictable ones that would lead to eventual dislocation.

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