Dislocations are the permanent displacement of two joint surfaces that have lost their normal relationship. When the joint surfaces are completely separated, the dislocation is said to be complete. When they are still partially in contact, it is said to be a subluxation.
On the other hand, a dislocation that is complicated by a wound that comes into contact with the outside of the joint is called an exposed or compound dislocation.
On the other hand, sprains are also like dislocations, they are traumatic injuries to a joint, caused by its sudden distension, but without permanent displacement of the joint surfaces. They are generally accompanied by the tearing or tearing of ligaments in the joint.
Sprains, which are also known as sprains, sometimes cause violent distension of a joint without dislocation, even causing the rupture of a ligament or muscle fibers.
WHAT ARE THE CAUSES OF DISLOCATIONS?
Dislocations are generally more common in men than in women. Most cases are seen in adulthood. They are less common in children, due to the elasticity of the bones, the joint capsule and the ligaments.
In the elderly, the greater fragility of the bones makes a fracture more likely than a dislocation. The shoulder and elbow are the joints that dislocate most frequently.
On the other hand, among the most common causes of dislocations are a fall on the hand, which can dislocate the shoulder, for example. Sometimes, intense muscle contraction can cause a dislocation; for example, when throwing a stone or yawning.
Occasionally, dislocation occurs spontaneously, or due to a slight trauma, due to a joint disease.
WHAT ARE THE SYMPTOMS OF DISLOCATIONS?
The main symptoms of dislocations are pain, deformity and decreased function. The pain is intense at first due to the tearing of the joint capsule, and then lessens unless a nerve is compressed or there is a simultaneous fracture.
Regarding deformity, when looking at and palpating the dislocated joint, changes in the contour can be observed (especially when compared to the healthy side), and changes in the relationship between the different bones. Often, if the affected limb segment is measured, lengthening or shortening of the same is observed.
It also happens that due to the new position of the bones and the action of the ligaments of the joint that did not tear, the movements of the joint are reduced or cancelled (antalgic position).
WHAT IS FIRST AID IN CASE OF DISLOCATIONS AND SPRAINS?
First aid treatment for a dislocation and sprains is more urgent than for a fracture, because the longer it has been since it occurred, the more difficult it is to reduce. Therefore, the patient should be immobilized and taken to the doctor or called immediately.
While waiting for the doctor to arrive, the first aid procedure cold cloths or an ice pack can be placed on the joint and immobilized.
We firmly believe that no one other than a doctor should try to reduce a dislocation. There have been cases where an amateur tried to reduce a dislocation that did not exist, and instead a fracture occurred. And in other cases, when trying to reduce a dislocation, a fracture occurred.
It has also happened that the person treating a dislocation has said that he has reduced it and six months later the affected person arrives with a dislocated limb. Therefore, in the case of a dislocation injury, one should never try to reduce the injury.
Of course, there can be exceptions. So if a dislocation occurs in a very remote place where there is no doctor, nor the possibility of getting one quickly, it is justified for the person providing first aid to try to reduce the dislocation, this being the first time dislocation be treated especially when it has just occurred, which is the best time.
First aid for shoulder dislocation
- Lay the patient on the floor, take the hand on the injured side with both hands, place a heel (without a shoe) in the armpit of the dislocated side and pull gradually.
- You will soon feel a bump indicating that the reduction has taken place. There are more elegant methods, but they are more dangerous.
- Keep the arm on the dislocated side crossed over the chest for a few days (with the hand on the side that was dislocated touching the healthy shoulder).
First aid for elbow dislocation
First aid for elbow dislocation is as follows:
- The simplest method is to simply extend the forearm and pull on the hand and wrist. However, this must be done with great care, as there is a risk of fracturing the olecranon.
- While the person performing the reduction holds the lower part of the arm with his fingers and presses the olecranon (elbow) with his thumbs, an assistant pulls on the semi-flexed forearm.
- Keep the arm in a sling for a few days.
First aid for lower jaw dislocation
The person with this type of dislocation has a characteristic appearance: a very open mouth that is impossible to close, a chin that is more prominent than normal and drooling. It is very difficult for him to speak, chew and swallow.
For this reason, the first aid in the case of a dislocation of the lower jaw is:
- Put your thumbs in the mouth, resting them on the last molars of the lower jaw.
- First apply downward pressure to "unhook" and then backwards.
- Immediately afterwards, place your thumbs on the outside of the dental arches (against the inside of the cheeks) to avoid being bitten. The reduction is generally easy.
- For a few days, avoid yawning and opening your mouth too wide.
WHAT ARE THE SYMPTOMS OF A SPRAIN
The main symptom of a sprain is very intense pain at the time of the injury. Later, the pain is aroused by the slightest movement or by palpating the point where the torn ligaments are.
On the other hand, marked swelling of the soft parts surrounding the joint soon appears. Then, ecchymosis, or extremely extensive bruises, appear. In general, the most common sprain is that of the ankle, since the common cause is the inward twisting of the foot.
In all sprains, it is prudent to obtain an X-ray, as there may be a fracture at the same time.
WHAT IS FIRST AID FOR SPRAINS?
After checking with an X-ray that there is no fracture at the same time, the first aid in case of sprains is:
- Place the sprained ankle or joint on a pillow, in an elevated position.
- Apply cold to the painful area, with an ice pack, a compress or a wrap of crushed ice or by means of compresses soaked in cold water. The purpose of keeping the area elevated and applying cold is to try to prevent bleeding and swelling, thereby relieving pain.
- After 24 hours, an alternating hot and cold bath can be applied to reduce swelling and then a very gentle massage (it should not hurt) applied by a trained person. In the elderly and rheumatic patients, it is prudent to mobilize early, but it is not prudent to allow walking for several days. The transition will be gradual. It is better not to massage than to do it badly.
- When the pain is very intense, it may be necessary to inject a solution of novocaine (procaine) into the affected area. Another useful method is to place strips of adhesive tape across the ankle. This has the disadvantage, however, of not allowing baths or massage.
- Between treatments and before starting to walk, bandage the joint with an elastic bandage.
- Some doctors prefer to put on a plaster cast to improve the healing of torn ligaments.
