Dislocation
Bones forced out of their normal position in a joint
Quick Facts
- Type: Acute musculoskeletal injury
- Common joints: Shoulder, fingers, knee, hip
- Main signs: Pain, deformity, can't move joint
- Action: Seek urgent medical care
Overview
A dislocation is an injury in which the bones that form a joint are forced out of their normal alignment, so the joint surfaces are no longer properly connected. It usually results from a fall, a blow, or a sports injury and most often affects the shoulder and fingers, though any joint, including the hip, knee, elbow, or jaw, can dislocate.
A dislocation is a medical emergency that needs prompt attention. The joint should be put back into place (reduced) by a trained professional, not forced by an untrained person, because doing so incorrectly can damage nearby nerves, blood vessels, and other tissues. With proper treatment most dislocations heal well, although some joints, especially the shoulder, can become prone to dislocating again.
The priority after a dislocation is to get the joint safely back into place and to make sure no nerves or blood vessels have been harmed. Keeping the injured joint still and getting medical help quickly gives the best chance of a smooth recovery and reduces the risk of complications.
Symptoms
A dislocated joint usually causes obvious and sudden symptoms:
- Intense pain at the joint
- A visibly deformed or out-of-place joint
- Swelling and bruising
- Inability to move the joint or use the limb normally
- Numbness, tingling, or weakness beyond the joint if nerves are affected
Sometimes a dislocation occurs alongside a fracture or torn ligaments. Signs that nearby nerves or blood vessels are affected, such as numbness, a cold or pale limb, or loss of a pulse, make the injury especially urgent.
Causes
Dislocations are caused by a force strong enough to push the bones of a joint out of position. Common causes include:
- Falls, such as landing on an outstretched hand or shoulder
- Sports injuries, particularly contact and high-impact sports
- Motor vehicle and other accidents
- A direct blow to a joint
Some people have joints that dislocate more easily, either because of a previous dislocation that stretched the supporting tissues or because of conditions that make the ligaments looser than normal.
Risk Factors
- Participation in contact or high-impact sports
- A previous dislocation of the same joint
- Conditions that cause loose or hypermobile joints
- Older age and conditions that increase the risk of falls
- High-risk activities and occupations
Diagnosis
A dislocation is diagnosed by examination and imaging:
- Physical examination: Assessing the deformity, the ability to move the joint, and checking the nerves, pulses, and circulation beyond the injury.
- X-rays: Confirm the dislocation and reveal any accompanying fracture.
- Other imaging: CT or MRI may be used to assess soft tissue, cartilage, or ligament damage, particularly for complex or recurrent dislocations.
Treatment
Treatment restores the joint to its normal position and supports healing. It should be carried out by trained medical staff.
- Reduction: Gently maneuvering the bones back into place, usually after pain relief or sedation. This should not be attempted by untrained people.
- Immobilization: A sling, splint, or brace to rest and protect the joint while it heals.
- Pain relief: Medications to control pain and inflammation.
- Rehabilitation: Physical therapy to restore strength, movement, and stability and to reduce the chance of another dislocation.
- Surgery: Sometimes needed for severe damage, recurrent dislocations, or when nerves, blood vessels, or torn tissues require repair.
Prevention and Recovery
- Use protective gear and proper technique during sports and high-risk activities
- Strengthen the muscles around vulnerable joints, especially after a previous dislocation
- Take steps to prevent falls at home, particularly for older adults
- Complete recommended rehabilitation to restore stability and reduce recurrence
- Warm up before exercise and avoid pushing a joint beyond its safe range
When to See a Doctor
A suspected dislocation should be treated as an emergency. Seek immediate medical care or call emergency services if a joint looks deformed, is intensely painful, or cannot be moved after an injury.
Do not try to force the joint back into place yourself, as this can cause serious damage. Seek urgent care right away if the limb beyond the injury becomes numb, cold, pale, or pulseless, or if there is a suspected dislocation of a major joint such as the hip or knee, as these can threaten the limb and need rapid treatment. While waiting for help, keep the joint still and apply ice to reduce swelling.
Frequently Asked Questions
Should I try to push a dislocated joint back in myself?
No. You should not try to force a dislocated joint back into place, because doing it incorrectly can damage nerves, blood vessels, ligaments, and other tissues. Keep the joint still, apply ice, and seek immediate medical care so it can be reduced safely by a trained professional.
How is a dislocation different from a fracture?
A dislocation is when bones are pushed out of their normal position in a joint, while a fracture is a break in a bone. The two can happen together, and X-rays are used to tell them apart and to guide treatment.
Is a dislocation an emergency?
Yes. A dislocation should be treated promptly because the joint needs to be put back into place and because nearby nerves and blood vessels can be affected. Seek immediate care, and treat it as especially urgent if the limb becomes numb, cold, pale, or pulseless.
Will a dislocated joint dislocate again?
It can. Some joints, particularly the shoulder, are prone to repeat dislocations, especially after the first one stretches the supporting tissues. Completing rehabilitation to strengthen and stabilize the joint reduces this risk, and surgery is sometimes recommended for recurrent dislocations.
What should I do while waiting for medical help?
Keep the injured joint still and supported in the position you found it, do not try to straighten or relocate it, and apply ice wrapped in a cloth to reduce swelling. Avoid eating or drinking in case sedation is needed, and get to medical care as soon as possible.
References
- Mayo Clinic. Dislocation.
- American Academy of Orthopaedic Surgeons. Dislocations.
- MedlinePlus, U.S. National Library of Medicine. Dislocations.
- National Health Service (NHS). Dislocated joint.