DISLOCATION OR SUBLUXATION
DESCRIPTIONDislocation is injury to a joint so that adjoining bones no longer touch each other. Subluxation is a minor dislocation. Joint surfaces still touch, but not in a normal relation to each other. The bones in the joints, especially the jaw, elbow, shoulder, knee and spine, are involved. Some infants are born with a hip dislocation.
Appropriate health care includes:
Physician's monitoring of general condition and medications. This may include manipulating your child's joint to reposition the bones.
Surgery to restore the joint to its normal position (sometimes). Recurring dislocation may require surgical reconstruction or replacement of the joint.
Self-care after the dislocation has been reduced.
SIGNS & SYMPTOMSSudden joint pain, swelling, or deformity after an injury.
Limited or absent movement around a joint.
CAUSESJerking a child sharply by the hand or arm.
Injury that stretches or tears ligaments that surround a joint and hold the bones together.
Shallow or abnormally formed joint surfaces (congenital).
Rheumatoid arthritis or other diseases of ligaments and tissue around a joint.
RISK FACTORSRheumatoid arthritis.
Family history of congenital hip dislocation.
Repeated injury to a joint.
PREVENTING COMPLICATIONS OR RECURRENCEAdvise a child who is involved in strenuous sports or heavy work to protect the involved joints and to use protective devices, such as wrapped elastic bandages, tape wraps, knee or shoulder pads, and special support stockings.
Your own observation of symptoms.
Medical history and physical exam by a doctor. (Infants should be examined for congenital hip dislocation at birth and at "well-baby" checkups.)
X-rays of the joint and adjacent bones.
POSSIBLE COMPLICATIONSDamage to nearby nerves or major blood vessels, causing numbness, coldness, and paleness.
Usually curable with prompt treatment. After the dislocation has been corrected, the joint may require immobilization with a cast or sling for 2 to 8 weeks.
HOME CAREImmediately after injury:
Apply ice packs to the involved joint to prevent swelling.
Use a splint or sling to prevent movement while transporting the injured child to the doctor.
If your doctor puts a cast on the joint, See Appendix 41 (Care of Casts).
MEDICATIONGeneral anesthesia or muscle relaxants to make joint manipulation possible.
Acetaminophen or aspirin to relieve moderate pain.
Narcotic pain relievers for severe pain.
See Medications section for information regarding medicines your doctor may prescribe.
Your doctor may prescribe:
Your child can resume normal activities gradually after treatment.
DIET & FLUIDS
Your child should drink only water before manipulation or surgery to correct the dislocation. Solid food makes general anesthesia more hazardous.
OK TO GO TO SCHOOL?When your child is comfortable enough to last through the day.
CALL YOUR DOCTOR IF
Your child has difficulty moving a joint after injury.
Any extremity becomes numb, pale, or cold after injury. This is an emergency!
Dislocations occur repeatedly that you can "pop" back into normal position.