Symptoms of dislocations

2021-01-26 12:00 AM

Synovial fluid secretes joint fluid that is responsible for feeding cartilage and lubricating joint surface and preventing joint infection.

Outline

Dislocations are abnormal movement between the ends of the bone causing the joint surfaces to deviate.

Recall some anatomical and physiological features.

Anatomy

One joint included.

The cusp and socket are where the long bone ends connect.

The ligaments are the means that hold the joints.

Synovial fluid secretes joint fluid that is responsible for feeding cartilage and lubricating joint surface and preventing joint infection.

Circulatory vessels: usually by ligaments covering the joints and bones of the body and bones.

Physiologic

The joint is active when the joint anatomy is normal.

Joints are round: There are many movements: form, close, rotate, etc. ... large joint movement amplitude (shoulder joint, hip joint).

Pulley joint: Only 2 folding movements, stretching, no horizontal shaking movements (elbow joints, knee joints).

When dislocated or accompanied by fractures, it is very easy to have stiffness, degeneration of the joints or osteoarthritis.

Epidemiology

Each age usually has a type of dislocation.

Children: Elbow dislocation.

Adults: Disability shoulder, hip joint.

Common dislocations: At young age, working age.

Men are more than women.

Cause and mechanism of dislocation.

Reason

Due to injury is mainly.

Traffic accidents.

Labor accident.

Sports accident.

School accident.

Due to pathology: osteoarthritis of the groin, shoulder joint dislocation due to delta muscle paralysis, due to congenital dislocation.

Mechanism

The mechanism of indirect injury: mainly, such as falling on the arm causes dislocation of the shoulder, elbow joint.

Direct Mechanism: May cause open dislocation. This type is rare.

Classification of dislocations

New dislocations: Right after the accident.

Old dislocation: 3 weeks after the accident.

Dislocations recurring: Dislocations many times, frequency> 8-10 times.

Injury pathology

Osteoarthritis

Broken joint.

Broken cap joint.

Fracture of the neck and femur (fracture of the femur, neck and arm).

Cartilage breakup in children continues.

Software

Damage to ligaments, covering of joints: tear, dilated.

The capillary vessels are damaged or mild depending on the degree of displacement of the bone head and depending on the vessels that feed each joint.

Vascular, nerve: elbow dislocation can cause blood vessel and arm nerve rupture, knee dislocation can damage the hamstring.

Clinical symptoms of dislocation

Mechanical symptoms

Pain: After the accident, the patient has a lot of pain but relieves it quickly when being immobilized.

Reduction or loss of movement of the joint.

Systemic symptoms

Minor dislocations: Does not affect the patient's whole body.

Major dislocations (hip joints): May cause traumatic shock.

Physical symptoms

Examine in a sequence: seeing, touching, measuring.

Look:

See if there is wound, joint fluid discharge?

Look at skin color on the joint area.

Some typical images of dislocation such as: Square shoulder in shoulder dislocation, sign of ax in elbow dislocation.

Touch:

Hollow joints: This is a sure sign of dislocation, easy to detect in shallow joints such as shoulder joints, elbow joints, difficult to detect in loose joints such as hip joints.

Palpation of the cusp in an abnormal position (abnormality): Palpation of the arm bone in the Delta groove -pidum in shoulder dislocation, the head below the arm bone rising up in front of the elbow in the elbow dislocation.

Elastic movements (spring sign): Pull the limb out of the dislocated position, then release the limb, the limb will return to its original position (Berger sign in the dislocated shoulder blade).

This is a sure sign of dislocation.

Also, can feel pain, swelling in the joint.

Chi: See the deformity of the whole limb.

Axial deviation.

Short spending.

Loss of the joint's normal range of motion.

Measure your limbs for this typical deformation, which is also a sure sign of dislocation.

Neurovascular examination: Getting a rotating artery, a cylindrical vessel in the upper limb; capture anterior tibial plateau, posterior tibial plateau in lower extremities, examine sensory and movement in fingertips to avoid missing damage

X-ray symptoms

X-ray purpose:

Definitely determine the dislocation.

Determination of comorbidities?

Result:

Type of dislocation.

Deviation of bone head from joint surface.

Complications of dislocation.

Early complications.

Nerve circuit damage

Due to pinching.

Due to crushing, breaking.

Open joints: Usually due to direct trauma, strong trauma mechanism. Finding this complication is easy, based on the clinical situation:

Visible face joint through soft tissue.

Joint fluid flows through the soft wound.

Pus overflow, discharge through the wound (if late).

Dislocations accompanied by fractures: X-ray to diagnose.

Sequelae

Muscle atrophy, stiffness in bad posture: The elbow is always in a stretched position ...

Osteoarthritis: common in central hip dislocation, shoulder and knee dislocation.

Cap-joint resorption: femoral cap (due to damage to the capillary vessels).

Calcification around joints: affects the mechanical function of joints.