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First aid for dislocations helps to limit the list of possible complications in the future. At the same time, not all patients understand how classic dislocation differs from other similar lesions such as fractures and deformities of the articular capsule.
Dislocation in professional terminology is the displacement of the bone at the point of its attachment to the joint. The result of the deviation is an unnatural shape of the joint, followed by a partial or complete loss of functionality of a limb or other part of the body.
Despite the stereotype that the injuries presented are accompanied exclusively by bone displacement, especially serious consequences affect the violation of the integrity of blood vessels and even nerves. Against this background, the knowledge of how to provide first aid and subsequent contact with a doctor is able to maintain the natural mobility of the patient.
Causes of destabilization
In order for assistance to have an almost instantaneous effect, it is extremely important to understand the primary source of the defeat that happened.
In short, a joint is a connection of bones that responds to the mobility of a limb. It is formed by the articular ends of both bones, which are covered with a cartilaginous layer. Cartilage is designed to soften and at the same time absorb friction during any movement. If the pathology concerns the knee joints, then the presence of an additional cartilage lining, which is called the meniscus, adds to the complexity.
All articular elements of the bone structure are hidden in the so-called articular bag, which contains a special fluid. Additionally, ligaments are attached to the joint, which are designed to fix it securely. The whole mechanism is a fairly strong natural structure, but under a number of circumstances even it fails.
As with contusions, often the cause of destabilization of the articular activity is various mechanical damage, external pressure, or classic injuries received during physical activity.
But if, during fractures, you can immediately pay attention to damage due to a number of specific alarming signs, then things are more complicated with dislocation. This is explained by the fact that in clinical practice there are a number of diseases that contribute to the onset of such a condition. Ailments undermine health methodically and slowly, which is why it is not always possible to recognize something is wrong instantly, as with sprains.
Among the uniaxial diseases that provoke such a serious deviation from the physiological norm, there are:
- dysplasia;
- arthritis;
- tuberculosis;
- oncological neoplasms of a benign or malignant nature;
- osteomyelitis.
All of the above applies to the camp of acquired injuries, when medical assistance is already provided on the spot due to circumstances. But sometimes dislocations are congenital format. This occurs when the intrauterine development of the fetus is abnormal. After birth, the baby is immediately diagnosed with dysplasia. Most often in children
the hip area or knee area falls under the scope of the disease.
Special classification
The sequence of deviation diagnostics provides for the need to assign a certain status to the dislocation according to several classifications. All such injuries can be sorted according to:
- origin;
- degree of displacement;
- condition of the skin;
- the statute of limitations.
Pre-medical support for newborns who have become a victim of intrauterine anomalies does not have a place to be. Instead, help lies in long-term therapy, which in the early stages has a beneficial effect in most situations.
Also, emergency medical care will turn out to be a useless exercise if the treatment was due to a pathological displacement, which is caused by a chronic illness. It is most effective to use a summary of pre-medical rules for cases of traumatic injury to the leg or other part of the body.
Orthopedics has its own classification according to the degree of displacement of the bone structure:
- full;
- incomplete.
The second version is also called subluxation, as it does not completely include the divergence of the ends of the joints. Some contact area still remains. At the full stage, the articular ends of the arm diverge completely.
A cursory examination of the problem area allows you to make an assessment of the skin. If the signs of destabilization include a violation of the integrity of the tissues, then this indicates an open type of dislocation. When the analogue is closed, the top layer remains intact.
But do not assume that the second subtype of injury is safer. In fact, it poses a serious threat, as it sometimes covers ruptured blood vessels. And with bleeding without an open wound surface, the layman usually cannot cope on his own.
The statute of limitations also affects the severity of the disease, so it was put into a separate classification. Fresh injuries cover a time interval of up to three days. Stale – from three days to two weeks. Old – the terms are higher than those indicated. The latter option is especially characteristic of lesions of the shoulder joint.
But, no matter what degree was assigned to the defeat, it must be certified according to the latest special sorting, which covers the division into the following groups:
- paralytic;
- complicated;
- habitual;
- irreducible.
The first point covers muscular paralysis, outweighing the strength of the antagonist muscles.
A correctly diagnosed complicated variant helps in the further preparation of therapy, as it allows you to identify complications such as nerve lesions and disorders of the main blood vessels. In the most dangerous scenario, the symptoms point to intra-articular or peri-articular fractures.
As for the shoulder, he most often has to deal with the usual class. Its peculiarity lies in periodically repeating dislocation at the same point. This is often caused by anatomical changes due to a number of pathologies, as well as muscle weakness or ligament problems.
The irreducible analogue covers chronic injuries, which are almost always accompanied by the penetration of tissues between the articular surfaces of the bone ends.
How to identify the characteristic symptoms?
To understand the signs of a possible dislocation, people use tables, physiological charts, and even a thematic presentation helps them. The latter may include information about adjacent injuries, which occurs with burns, frostbite.
Despite the fact that all types of dislocations have their own characteristics, they can still be combined into a common list. With such injuries, a person complains of:
- sharp pain with increasing intensity when trying to make a movement;
- redness of the skin;
- swelling;
- local temperature, which means an increase in temperature in the affected area;
- articular deformity, covering a change not only in shape, but also in size;
- change in the length of the affected limb, which is more suitable for an ankle injury;
- the articular end, which is palpable in the “wrong place”.
Rarely, such foot or hand problems are additionally accompanied by generalized fever and chills. There are frequent cases of bruising. And with compression of the nerve endings, the victim complains of a partial or complete loss of sensitivity.
Differences between a fracture and a dislocation
In order to correctly use measures to alleviate the patient’s condition, you first need to determine whether a dislocation or fracture has occurred with the victim. Usually the task presented is beyond the power of a person who does not have the appropriate education. The final verdict will be made only after the victim undergoes an X-ray examination. A black-and-white image will reveal a possible fracture of the bone structure.
But even without radiography, there are primitive methods that make it more likely to identify the exact format of the lesion. The essential difference of the fracture lies in the following aspects:
- The presence of bruising and swelling strictly above the damaged part with subsequent spread to the surrounding tissues much later. A dislocation also forms a bruise with swelling over the problem joint, followed by “spreading” to the surrounding skin.
- Probing of bone fragments is characteristic of a classic fracture with displacement. With a dislocation, only torn articular surfaces can be felt.
- The fracture provides for an intense pain syndrome exclusively in the zone of destruction of the integrity of the bone. With a dislocation, the pain increases when trying to probe the damaged area.
Separately, you need to pay attention to the length of the limb. With a dislocation, only this value changes, while a fracture is characterized by a change not only in length, but also in shape.
Basics of first aid
Immediately after the detection of alarming symptoms, you should call an ambulance team, or if you feel relatively normal, go on your own to the trampoint at the hospital.
The rules of first aid dictate that the instructions for the protocol must be followed. First, the patient is seated or laid down to give the injured part a comfortable position. If there have been violations of the integrity of the skin, the open wound surface will need to be treated with an antiseptic solution and applied over a bandage with a sterile bandage.
But giving painkillers or even an intramuscular injection of an analgesic without first consulting a doctor is strictly prohibited. Such amateur performance can seriously lubricate the overall clinical picture.
Next, you will need to immobilize the problem area with an elastic bandage or even a splint. Material for it can be obtained almost everywhere, using even just boards or surrounding branches as a basis.
Before you begin to wind the splint to the injured limb, you must first cover it with a cloth. You will have to make sure that the edges of the bandage do not affect soft tissues or nerves.
Regardless of where exactly the damage occurred, you cannot try to straighten the dislocation on your own. Such a serious event should only be carried out by an experienced traumatologist.
To reduce swelling, it is recommended to apply ice or something cold, previously wrapped in a towel. Leave the cold is allowed no more than 20 minutes. Then you need to maintain an interval of a couple of minutes before applying ice again. This will protect the victim from frostbite, which blocks normal blood flow.
If you ignore all the signs of even a relatively simple dislocation, then you can earn a number of complications. Some of them are irreversible processes. Among the most common side effects of ignoring pathology, partial or even complete rupture of the joint capsule is noted.
No less often in victims, along the way, a violation of the integrity of large vessels, nerves, and marginal fractures is detected. With shoulder injuries, traumatic plexitis is quite a common occurrence. If you do not set everything back in time, you will be able to reach even gangrene. And the most severe degree of femoral dislocation is called tissue necrosis.
In order not to start the deviation to such serious consequences, you should immediately seek advice from an orthopedist-traumatologist after detecting dangerous signs.