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Dislocation Closed Reduction

Treatment of Joint Dislocations and Capsular Ruptures

Joint dislocation occurs when the articulating surfaces of a joint become misaligned, while the joint capsule remains intact. Dislocations are typically caused by excessive external force and commonly affect areas such as the shoulder, patella, fingers, and acromioclavicular joint. Clinical symptoms include severe joint pain, restricted mobility, and potential joint deformity.

 

When a joint dislocation occurs, the bones that comprise the joint are forcibly displaced from their normal position. This displacement can result from various external factors, such as accidental falls, sports injuries, or traumatic impacts. Dislocations often cause intense pain, rendering the affected joint immobile and unusable.

 

Common Sites of Joint Dislocation

  1. Shoulder Dislocation: Shoulder dislocation is one of the most common types, particularly among young individuals and athletes. It typically occurs in the glenohumeral joint and may result from direct impact to the shoulder or sudden rotational movements of the arm.

  2. Patellar Dislocation: Patellar dislocation refers to the displacement of the kneecap (patella) from its normal alignment on the femur. This type of dislocation is often caused by external forces applied to the front of the knee, such as during a fall or twisting injury.

  3. Finger Dislocation: Finger dislocation involves the displacement of the bones within a finger joint. This can occur when the finger is subjected to excessive force or twisting, often seen in sports or accidents.

  4. Acromioclavicular Joint Dislocation: Dislocation of the acromioclavicular joint occurs between the scapula and the clavicle. This type of dislocation is usually the result of significant trauma to the shoulder, such as a strong impact or twisting of the shoulder girdle.

 

Procedures

  •  Preventive Measures: Before performing reduction surgery, the doctor may take certain preventive measures to minimize surgical risks. This may include appropriate antibiotic prophylaxis and proper anesthesia management. Patients should also follow the doctor's instructions, such as fasting or discontinuing certain medications.

  • Reduction Procedure: Once preparations are complete, the doctor will reposition the dislocated joint or bone to its correct alignment. The doctor may use techniques such as gentle traction, pressure, or rotation to achieve the reduction. Sometimes, surgical instruments like clamps or stabilizing devices may be needed to help secure and maintain the reduction.

  • Repair and Stabilization: In some cases, the doctor may need to further repair damaged tissues, such as muscles, ligaments, or bones. This may involve using pins, screws, metal plates, or other fixation devices to stabilize and secure the structure.

 

Preparation

  • Fasting Instructions: Patients are generally required to fast for 6 hours before surgery, meaning no food intake for 6 hours prior to the procedure. A small amount of plain water is allowed until 2 hours before the surgery.

  • Preoperative Medications: Take any prescribed medications as instructed. If you are currently taking medications that affect blood clotting, such as Aspirin, Warfarin, Xarelto, Pradaxa, or herbal medicines, please inform your doctor as soon as possible.

  • The doctor will explain the reasons for the procedure, the process involved, and any potential complications. After understanding this information, the patient can sign the consent form.

 

Wound Care

  • Follow specific activity restrictions, attend regular follow-up appointments, and avoid excessive activity or the recurrence of injuries. Adhering to the doctor’s instructions and recommendations is crucial for ensuring optimal outcomes.

  • Recovery time varies depending on the location and severity of the reduction. Generally, simpler reduction surgeries may require a few weeks for recovery, while more complex surgeries may take longer.

  • In certain cases, the doctor may recommend using braces, orthotic devices, or assistive equipment to support and stabilize the joint, facilitating the recovery process.

  • Maintaining good posture can reduce joint stress and promote recovery. Proper posture is essential during daily activities.

 

Follow-up and Recovery

  • For 3 to 12 months after surgery, avoid lifting heavy objects and engaging in vigorous exercise or competitive activities until the joint has fully healed.

  • Consuming foods rich in calcium and vitamin D can help improve bone strength.

  • If your wound exhibits any of the following conditions, please contact your primary physician immediately:

    • Increased pain and swelling

    • Heavy bleeding or thick discharge

    • Loss of sensation at the surgical site

    • The affected limb or toes becoming cold or pale

    • Symptoms include coughing, shortness of breath, chest pain, rapid heartbeat, chills, or fever.

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Reference

BMJ Best practice. Joint dislocation. Available at : https://bestpractice.bmj.com/topics/en-us/583

 

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