Joint Dislocation

First aid for a dislocation

1. Do not move or straighten the joint. Attempting to push it back can damage nerves, blood vessels and bone.
2. Immobilize it in the position you find it, using a sling, splint, rolled magazine or padding.
3. Apply ice wrapped in a cloth for up to 20 minutes to reduce swelling and pain.
4. Remove rings, watches and tight items near the injury before swelling increases.
5. Do not eat or drink in case sedation or surgery is needed.
6. Get medical care. Call 911 for hip, knee or elbow dislocations, loss of pulse or feeling, or open wounds.

Signs and symptoms of a dislocation

• obvious deformity: the joint looks out of place, misshapen or the limb looks shorter or rotated
• intense pain, especially when trying to move
• swelling and bruising
• inability to move the joint or bear weight
• numbness, tingling or weakness beyond the joint if a nerve is stretched
• a feeling that the joint "popped out"

Signs of a finger dislocation

• the finger is bent at an abnormal angle, usually at the middle joint
• swelling and inability to straighten or bend it
• the finger looks crooked or shorter

Finger dislocations are common in ball sports. Many are reduced easily by a clinician, followed by an X-ray, then buddy taping or a splint for a few weeks. See finger dislocation.

Dislocation of bones in the foot

Dislocations in the foot include the toes, the ankle, the subtalar joint below the ankle, and the midfoot (Lisfranc injury), where the long bones of the foot separate from the small bones of the arch. Lisfranc injuries cause pain and swelling across the top of the midfoot, bruising on the sole and inability to bear weight. They are easily mistaken for a sprain and often need surgery. See dislocation of the foot.

Common dislocations

Dislocation vs fracture vs sprain

They often occur together. A fracture-dislocation needs X-rays before and after reduction.

Causes and risk factors

• contact sports, skiing, gymnastics and trampolines
• falls, especially in older adults
• motor vehicle crashes
• previous dislocation, which loosens ligaments
• joint hypermobility conditions such as Ehlers-Danlos syndrome
• artificial joints, particularly hip replacements in the first months

Diagnosis

A clinician examines the joint and checks circulation, sensation and movement below the injury. X-rays confirm the dislocation and look for fractures. CT or MRI is used to evaluate ligament, cartilage and complex injuries, such as Lisfranc injuries, after reduction.

Treatment

• Reduction: the clinician gently maneuvers the bones back into place, often with pain relief, sedation or anesthesia. Pain eases dramatically once the joint is back in position.
• Post-reduction X-ray to confirm alignment.
• Immobilization: a sling, splint or cast for days to weeks, depending on the joint.
• Pain relief: acetaminophen (paracetamol) or ibuprofen at the label dose, ice and elevation.
• Rehabilitation: physical therapy to restore movement, strength and stability.
• Surgery: when reduction fails, bones are broken, ligaments are badly torn, or the joint keeps dislocating (recurrent dislocation).

Recovery and preventing re-injury

Most people recover in 6 to 12 weeks, with return to sport often taking longer. Young people with shoulder or kneecap dislocations are at high risk of recurrence. Strengthening, balance training, taping or braces for sport, and fall prevention for older adults all reduce the risk.

Frequently asked questions

What are the signs of a dislocated joint?

A dislocated joint usually looks deformed or out of place, is intensely painful, swells and cannot be moved normally. There may be numbness or tingling beyond the joint. If you suspect a dislocation, immobilize it and get medical care.

What are the signs of a dislocated finger?

A dislocated finger is bent at an odd angle, often at the middle knuckle, with swelling, pain and inability to bend or straighten it. It should be reduced by a clinician and X-rayed to check for a fracture, then splinted or buddy-taped.

Can a dislocated bone in the foot heal on its own?

No. Dislocations in the foot, including Lisfranc midfoot injuries, need medical treatment. Without proper alignment they can cause long-term pain, arthritis and flat foot. Many need surgery to hold the bones in place while ligaments heal.

Should you pop a dislocated joint back in?

No. Trying to force a joint back can damage blood vessels, nerves and bone, and may hide a fracture. Immobilize the joint and get medical help. A clinician will reduce it safely, often with pain relief, and confirm alignment with X-rays.

How long does a dislocation take to heal?

Most dislocations heal in 6 to 12 weeks, depending on the joint and any associated damage. Fingers may recover in a few weeks; shoulders and hips take longer. Physical therapy is important to restore strength and prevent recurrence.