When a bone slips out of the joint that holds it, it has dislocated. Almost all the joints in the body can be dislocated, but a clear example is the shoulder: the top of the arm bone fits into a joint that’s part of the shoulder, and it can pop out of that joint. People can also dislocate their fingers, knees, elbows, hips, and many other joints. A dislocation that is not repaired is likely to cause damage to the ligaments and nerves in the area and could impede blood flow and damage the blood vessels, and a dislocated joint should be treated as an emergency.
If you have injured a bone or joint, it could be hard to tell whether the bone is broken or the joint is dislocated, and you should go to the emergency room or see your doctor as soon as you can. Your doctor will assess your injury visually and manually, examining the area for broken skin, problems with circulation, or other abnormalities. If your doctor suspects that you have a broken bone or a dislocated joint, they will order an x-ray or other imaging so that they can see the bones inside the body and determine the exact nature and location of the injury.
If you have dislocated a joint, the recommended treatment will vary depending on the location of the dislocation, and it can also be affected by the gravity of the injury. In more mild cases, RICE treatment -- rest, ice, compression, elevation -- allows the affected joint to naturally return to its rightful place. While this method can be effective, the joint is only healing itself because it is being allowed to; if you have a dislocated joint that is not properly diagnosed and you don’t rest and elevate it and apply ice and pressure to it, it will not heal and is likely to get worse.
When RICE treatment does not repair the dislocated joint, your doctor will manually reposition the connection of the joint to its proper place. Before this procedure, called manipulation, your doctor will provide an anesthetic or sedative so that your body is relaxed during this procedure. Then, you may be asked to keep the joint stable for a period of time, with a splint, a sling, or cast, which will protect the joint as it heals. You may also get a prescription for pain medication, though most patients report that pain diminishes quickly when the joint is manipulated back into place.
If the dislocation injured your blood vessels or nervous system, or if your joints cannot be properly relocated manually by your doctor, surgery may be necessary. Surgery may also be recommended for patients who have certain joints that chronically dislocate; the joint can be reconstructed and repaired, restoring its integrity. If the joint has dislocated and the bone is lacking integrity, the joint may need to be replaced. This is more common among elderly patients, whose hips frequently need to be replaced when they have sustained excessive impact, either all at once or over time, and can no longer join the bones they were meant to join.