Treating Dislocated Bones and Joints
Signs and Symptoms of a Dislocated Bone
Dislocations are the separations of bone joints causing the bones to go out of proper alignment. These misalignments can be extremely painful and can cause an impairment of nerve or circulatory function below the area affected. You must place these joints back into alignment as quickly as possible.
Signs and symptoms of dislocations are joint pain, tenderness, swelling, discoloration, limited range of motion, and deformity of the joint. You treat dislocations by reduction, immobilization, and rehabilitation.
Types of Dislocations
There are various types of dislocations. For shoulder dislocations, anterior dislocations are separations resulting in the shoulder joint coming out to the front of the body, and posterior are dislocations to the rear of the shoulder. Anterior shoulder dislocations can be manually set but posterior dislocations, which are much rarer (and often the result of seizures or electrical shock) cannot be set manually.
Treating a Dislocated Joint
Reduction or "setting" is placing the bones back into their proper alignment. You can use several methods, but manual traction or the use of weights to pull the bones are the safest and easiest. Once performed, reduction decreases the victim’s pain and allows for normal function and circulation. Without an X ray, you can judge proper alignment by the look and feel of the joint and by comparing it to the joint on the opposite side.
Immobilization is nothing more than splinting the dislocation after reduction just as you would splint a bone fracture. You can use any field-expedient material for a splint or you can splint an extremity to the body. The basic guidelines for splinting are as follows:
- Splint above and below the fracture site.
- Pad splints to reduce discomfort.
- Check circulation below the fracture after making each tie on the splint.
To rehabilitate the dislocation, remove the splints after 7 to 14 days. Gradually use the injured joint until fully healed.
Treat a Dislocated Finger or Toe
- Step directly in front of the injured person and take the injured finger or toe in your hands. Grip firmly at the base of the joint with one hand and grip the tip of the finger or toe with the other hand. Keep the joint slightly bent while you position yourself.
- Pull the tip of the finger or toe with one and and push the joint back into place with the other hand.
- Secure material for the splint. It should be straight and firm. A small stick or rolled up cloth will suffice.
- Place the splint under the finger. Make sure it is long enough to extend into the palm of the hand.
- Tie a strip of cloth above and below the fracture, around the finger and splint, and around the finger next to it for stability. Do not tie the splint too tightly and do not tie it directly over the fractured bone.
Treat a Dislocated Shoulder
Dislocated shoulders are very painful and scary. The more a person fights the pain, the tighter the muscles become. Try to calm the person down first. It is much easier to relocate the dislocated shoulder if the muscles are relaxed.
- Make sure the arm is in a resting position and hanging down.
- Bend the elbow up 90 degrees so the forearm is parallel to the ground.
- Rotate the arm (and shoulder) inward towards the chest to make a “L” shape.
- Keeping the upper arm stationary, slowly rotate the arm outward.
- Have the patient make a fist and hold it.
- With your other hand, grip the wrist and push back slowly so the arm goes back slightly beyond 90 degrees from the chest. The is painful but the shoulder should be coaxed back into place.
- Repeat this process until the shoulder is relocated. Since the shoulder may be tight, this may take a few tries before the shoulder goes back into place.
Treat a Dislocated Knee or Elbow
Do not try to reset a dislocated knee or elbow. Attempting to reset the knee or elbow can tear tissues and cause further damage. Instead, splint the knee or elbow as you would a broken bone insuring the joint is immobilized with wads of cloth placed in any gaps between the splint and the injured extremity.