Joint Dislocation
Bones of a joint forced fully out of their normal position
Quick Facts
- Type: Joint injury
- Common causes: Falls, sports, accidents
- Often affected: Shoulder, finger, kneecap, hip
- Seek care: Urgently — treat as a medical emergency
Overview
A joint dislocation happens when the bones that meet at a joint are pushed completely out of their normal alignment. This is different from a sprain, where ligaments are stretched or torn but the joint stays in place, and from a partial dislocation (subluxation), where the bones only partly separate. A full dislocation usually causes obvious deformity and an inability to move the joint.
Dislocations most often affect the shoulder, fingers, kneecap, elbow, and sometimes the hip. They are painful and should be treated as an emergency, because the joint needs to be put back into place promptly and nearby nerves and blood vessels can be at risk. With proper treatment most joints recover well, though some are prone to dislocating again.
Symptoms
A dislocated joint typically causes:
- A visibly deformed or out-of-place joint
- Intense pain, especially with any attempt to move
- Swelling and bruising around the joint
- Inability to move or use the joint normally
- Numbness, tingling, or weakness beyond the joint if a nerve is affected
A pale, cold, or pulseless limb beyond a dislocation is a warning sign that blood flow may be compromised, which is a medical emergency.
Causes
Dislocations result from force that overcomes the joint's stability:
- Falls: Landing on an outstretched hand or directly on a joint.
- Sports injuries: Contact sports and collisions, or sudden twisting.
- Accidents: Motor vehicle crashes can cause high-energy dislocations such as the hip.
- Trauma to a vulnerable joint: The shoulder is especially prone because of its wide range of motion.
Some conditions that make ligaments unusually loose, such as Ehlers-Danlos syndrome, allow joints to dislocate with less force.
Risk Factors
- Participation in contact or high-impact sports
- A previous dislocation of the same joint
- Naturally loose or hypermobile joints
- Connective tissue disorders affecting ligaments
- Older age and falls
- Activities with a high risk of trauma
Diagnosis
A clinician usually recognizes a dislocation from its appearance and confirms it with imaging:
- Physical exam: Inspecting the deformed joint and checking circulation, sensation, and movement beyond the injury.
- X-rays: Confirm the dislocation, show its direction, and reveal any accompanying fracture.
- Further imaging: CT or MRI may be used for complex joints or to assess soft tissue damage after the joint is reduced.
Treatment
The main goal is to return the bones to their normal position safely:
- Reduction: A trained clinician maneuvers the joint back into place, often with pain relief or sedation. This should not be attempted by untrained people, as forcing a joint can cause further damage.
- Immobilization: A sling, splint, or brace holds the joint while ligaments and tissues heal.
- Pain management: Medication and ice ease pain and swelling.
- Rehabilitation: Physical therapy restores strength and range of motion and reduces the risk of repeat dislocation.
- Surgery: May be needed for joints that dislocate repeatedly, or when ligaments, blood vessels, or nerves are badly damaged.
After reduction, circulation and sensation are rechecked to ensure no structures were injured.
Prevention
- Wear protective gear during contact sports
- Strengthen the muscles supporting vulnerable joints
- Use good technique and conditioning in sport
- Reduce fall hazards at home and underfoot
- Follow rehabilitation fully after a first dislocation to lower the chance of recurrence
When to See a Doctor
A suspected joint dislocation is a medical emergency. Seek immediate care and do not try to push the joint back yourself. Get emergency help right away if:
- The joint looks deformed or out of place
- The limb beyond the joint is numb, tingling, pale, or cold
- There is severe pain or you cannot move the joint
- The skin is broken over the injury
While waiting for help, keep the joint still, support it in the position found, and apply ice if available.
Frequently Asked Questions
Should I try to put a dislocated joint back in place myself?
No. Forcing a joint back can damage nerves, blood vessels, ligaments, or bone, and there may be a hidden fracture. Keep the joint still, support it, apply ice, and seek emergency care so a trained clinician can reduce it safely.
What is the difference between a dislocation and a sprain?
In a dislocation the bones of a joint are forced fully out of position, usually causing visible deformity. In a sprain the ligaments are stretched or torn but the joint stays aligned. Dislocations generally need urgent reduction, while many sprains heal with rest and support.
Which joints dislocate most often?
The shoulder is the most commonly dislocated large joint because of its wide range of motion. Fingers, the kneecap, and the elbow are also frequently dislocated, while hip dislocations usually result from high-energy trauma.
Will a dislocated joint dislocate again?
It can. Once a joint has dislocated, the supporting ligaments may be looser, raising the risk of recurrence, especially in the shoulder. Completing rehabilitation and, in some cases, surgery helps stabilize the joint and reduce repeat dislocations.
When is a dislocation an emergency?
Treat all suspected dislocations as urgent. Seek immediate care, and especially if the limb beyond the joint is numb, pale, cold, or pulseless, the skin is broken, or pain is severe. These signs suggest damage to nerves or blood flow that needs prompt treatment.
References
- MedlinePlus, U.S. National Library of Medicine. Dislocations.
- American Academy of Orthopaedic Surgeons (OrthoInfo).
- Mayo Clinic. Dislocation: First aid.
- Merck Manual. Dislocations.