Editing Joint dislocation

{{short description|Medical injury}}
{{Distinguish|sprain}}
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{{Infobox medical condition (new)
| name            = Joint dislocation
| image           = Ankledislocation.JPG
| caption         = A traumatic dislocation of the [[tibiotarsal joint]] of the ankle with distal [[fibular]] fracture. Open arrow marks the [[tibia]] and the closed arrow marks the [[Talus bone|talus]].
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A '''joint dislocation''', also called '''luxation''', occurs when there is an abnormal separation in the [[joint]], where two or more bones meet.<ref name="packard">{{cite web | title = Dislocations | work = Lucile Packard Children’s Hospital at Stanford. | access-date = 3 March 2013 | url = http://www.lpch.org/DiseaseHealthInfo/HealthLibrary/orthopaedics/dislocat.html | archive-url = https://web.archive.org/web/20130528153236/http://www.lpch.org/DiseaseHealthInfo/HealthLibrary/orthopaedics/dislocat.html| archive-date=28 May 2013}}</ref> A partial dislocation is referred to as a [[subluxation]]. Dislocations are commonly caused by sudden [[Trauma (medicine)|trauma]] to the joint like during a car accident or fall. A joint dislocation can damage the surrounding [[ligament]]s, [[tendon]]s, [[muscle]]s, and [[nerve]]s.<ref>{{cite journal | vauthors = Smith RL, Brunolli J | title = Shoulder kinesthesia after anterior glenohumeral joint dislocation | journal = Physical Therapy | volume = 69 | issue = 2 | pages = 106–112 | date = February 1989 | pmid = 2913578 | doi = 10.1093/ptj/69.2.106 }}</ref> Dislocations can occur in any major joint (shoulder, knees, hips) or minor joint (toes, fingers). The most common joint dislocation is a shoulder dislocation.<ref name=packard />

The treatment for joint dislocation is usually by closed [[reduction (orthopedic surgery)|reduction]], that is, skilled manipulation to return the bones to their normal position. Only trained medical professionals should perform reductions since the manipulation can cause injury to the surrounding soft tissue, nerves, or vascular structures.<ref name="Skelley 246–255">{{cite journal | vauthors = Skelley NW, McCormick JJ, Smith MV | title = In-game Management of Common Joint Dislocations | journal = Sports Health | volume = 6 | issue = 3 | pages = 246–255 | date = May 2014 | pmid = 24790695 | pmc = 4000468 | doi = 10.1177/1941738113499721 }}</ref>

==Signs and Symptoms==
The following symptoms are common with any type of dislocation.<ref name=packard />
* Intense pain<ref name="McMahon_2021" />
* Joint instability<ref name="McMahon_2021" />
* Deformity of the joint area<ref name="McMahon_2021" />
* Reduced muscle strength<ref name="McMahon_2021" />
* Bruising or redness of the joint area<ref name="McMahon_2021" />
* Difficulty moving joint<ref name="McMahon_2021" />
* Stiffness<ref name="McMahon_2021" />

=== Complications ===
Joint dislocations can have associated injuries to surrounding tissues and structures, including muscle strains, ligament and tendon injuries, neurovascular injuries, and fractures.<ref name="Khiami S51–S57" /><ref name="Gómez-Bermúdez_2021">{{cite journal | vauthors = Gómez-Bermúdez SJ, Vanegas-Isaza D, Herrera-Almanza L, Roldán-Tabares MD, Coronado-Magalhaes G, Fernández-Lopera JF, Martínez-Sánchez LM | title = [Vascular injury associated with knee dislocation] | journal = Acta Ortopedica Mexicana | volume = 35 | issue = 2 | pages = 226–235 | date = 2021 | pmid = 34731929 | doi = 10.35366/101872 | doi-access = free }}</ref><ref name="Heineman_2023" /><ref name="Borchers_2012" /> Depending on the location of the dislocation, there are different complications to consider.

In the shoulder, vessel and nerve injuries are rare, but can cause many impairments and requires a longer recovery process.<ref name="Khiami S51–S57">{{cite journal | vauthors = Khiami F, Gérometta A, Loriaut P | title = Management of recent first-time anterior shoulder dislocations | journal = Orthopaedics & Traumatology, Surgery & Research | volume = 101 | issue = 1 Suppl | pages = S51–S57 | date = February 2015 | pmid = 25596982 | doi = 10.1016/j.otsr.2014.06.027 | doi-access = free }}</ref> Knee dislocations are rare, but can be complicated by injuries to arteries and nerves, leading to limb-threatening complications.<ref name="Gómez-Bermúdez_2021" /> Degenerative changes following injury to the wrist are common, with many developing arthritis.<ref name="Heineman_2023">{{cite journal | vauthors = Heineman N, Do DH, Golden A | title = Carpal dislocations | journal = The Journal of Hand Surgery, European Volume | volume = 48 | issue = 2_suppl | pages = 11S–17S | date = September 2023 | pmid = 37704022 | doi = 10.1177/17531934231183260 | doi-access = free }}</ref> Persistent nerve pain years after the initial trauma is not uncommon.<ref name="Heineman_2023" /> Most finger dislocations occur in the middle of the finger (PIP) and are complicated by ligamentous injury (volar plate).<ref name="Borchers_2012">{{cite journal | vauthors = Borchers JR, Best TM | title = Common finger fractures and dislocations | journal = American Family Physician | volume = 85 | issue = 8 | pages = 805–810 | date = April 2012 | pmid = 22534390 | url = https://pubmed.ncbi.nlm.nih.gov/22534390 }}</ref> Since most dislocations involving the joint near the fingertip (DIP joint) are due to trauma, there is often an associated fracture or tissue injury.<ref name="Borchers_2012" /> [[Hip dislocation]]s are at risk for osteonecrosis of the femoral head, [[femoral head fracture]]s, the development of [[osteoarthritis]], and [[sciatic nerve]] injury.<ref>{{cite book | vauthors = Masiewicz S, Mabrouk A, Johnson DE | chapter = Posterior Hip Dislocation |date=2025 | title = StatPearls | chapter-url=https://www.ncbi.nlm.nih.gov/books/NBK459319/ |access-date=2025-01-23 |place=Treasure Island (FL) |publisher=StatPearls Publishing |pmid=29083669 }}</ref><ref>{{cite book | vauthors = Graber M, Marino DV, Johnson DE | chapter = Anterior Hip Dislocation |date=2025 | title = StatPearls | chapter-url=https://www.ncbi.nlm.nih.gov/books/NBK507814/ |place=Treasure Island (FL) |publisher=StatPearls Publishing |pmid=29939591 }}</ref> Given the strength of ligaments in the foot and ankle, ankle dislocation-fractures can occur.<ref>{{cite journal | vauthors = Lawson KA, Ayala AE, Morin ML, Latt LD, Wild JR | title = Republication of "Ankle Fracture-Dislocations: A Review" | journal = Foot & Ankle Orthopaedics | volume = 8 | issue = 3 | pages = 24730114231195058 | date = July 2023 | pmid = 37582190 | pmc = 10423454 | doi = 10.1177/24730114231195058 }}</ref>

==Causes==

Joint dislocations are caused by trauma to the joint or when an individual falls on a specific joint.<ref name="McMahon_2021" /> Great and sudden force applied, by either a blow or fall, to the joint can cause the bones in the joint to be displaced or dislocated from their normal position.<ref name=":0">{{cite web | url = https://www.nlm.nih.gov/medlineplus/ency/article/000014.htm | work = U.S. National Library of Medicine | title = Dislocation }}</ref> With each dislocation, the ligaments keeping the bones fixed in the correct position can be damaged or loosened, making it easier for the joint to be dislocated in the future.<ref name=":0" />

=== Risk Factors ===
A variety of risk factors can predispose individuals to joint dislocation.<ref name=":0" /> They can vary depending on location of the joint. Genetic factors and underlying medical conditions can further increase risk.<ref name=":1" /> Genetic conditions, such as [[Hypermobility (joints)|hypermobility]] syndrome and [[Ehlers-Danlos syndrome]] put individuals at increased risk for dislocations.<ref name=":1">{{Cite web |date=2017-09-24 |title=Ehlers-Danlos syndromes | work = Genetic and Rare Diseases Information Center (GARD) – an NCATS Program |url=https://rarediseases.info.nih.gov/diseases/6322/ehlers-danlos-syndromes |access-date=2025-01-16 |archive-url=https://web.archive.org/web/20170924001628/https://rarediseases.info.nih.gov/diseases/6322/ehlers-danlos-syndromes |archive-date=2017-09-24 }}</ref> Hypermobility syndrome is an inherited disorder that affects the ligaments around joints.<ref name="pmid26731093">{{cite journal | vauthors = Ruemper A, Watkins K | title = Correlations Between General Joint Hypermobility and Joint Hypermobility Syndrome and Injury in Contemporary Dance Students | journal = Journal of Dance Medicine & Science| volume = 16 | issue = 4 | pages = 161–6 | date = December 2012 | pmid = 26731093 | doi =  10.1177/1089313X1201600403}}</ref> The loosened or stretched ligaments in the joint provide less stability and allow for the joint to dislocate more easily.<ref name="pmid26731093" /> Dislocation can also occur because of conditions such as [[rheumatoid arthritis]].<ref name="Subagio_2023">{{cite journal | vauthors = Subagio EA, Wicaksono P, Faris M, Bajamal AH, Abdillah DS | title = Diagnosis and Prevalence (1975-2010) of Sudden Death due to Atlantoaxial Subluxation in Cervical Rheumatoid Arthritis: A Literature Review | journal = TheScientificWorldJournal | volume = 2023 | pages = 6675489 | date = 2023-10-05 | pmid = 37841539 | pmc = 10569890 | doi = 10.1155/2023/6675489 | doi-access = free | veditors = Dalal V }}</ref> In Rheumatoid arthritis the production of synovial fluid decreases, gradually causing pain, swollen joints, and stiffness.<ref name="Subagio_2023" /> A forceful push causes friction and can dislocate the joint.<ref name="Subagio_2023" /> Notably, joint instability in the neck is a potential complication of rheumatoid arthritis.<ref name="Subagio_2023" />

Participation in sports, being male, variations in the shape of the joint, being older, and joint hypermobility in males are risk factors associated with an increased risk of first time dislocation.<ref name="Wright_2024">{{cite journal | vauthors = Wright A, Ness B, Spontelli-Gisselman A, Gosselin D, Cleland J, Wassinger C | title = Risk Factors Associated with First Time and Recurrent Shoulder Instability: A Systematic Review | journal = International Journal of Sports Physical Therapy | volume = 19 | issue = 5 | pages = 522–534 | date = 2024-05-01 | pmid = 38707855 | pmc = 11065770 | doi = 10.26603/001c.116278 }}</ref> Risk factors for ''recurrent'' dislocation include participation in sports, being a young male, a history of a previous dislocation with an associated injury, and any history of previous dislocation.<ref name="Wright_2024" />

==Diagnosis==
Initial evaluation of a suspected joint dislocation begins with a thorough patient history, including mechanism of injury, and physical examination. Special attention should be focused on the neurovascular exam both before and after [[Reduction (orthopedic surgery)|reduction]], as injury to these structures may occur during the injury or during the reduction process.<ref name="Skelley 246–255"/> Imaging studies are frequently obtained to assist with diagnosis and to determine the extent of injury.
[[File:Dislocated Finger XRay.png|thumb|Radiograph of right fifth finger dislocation]]

=== Imaging Types ===

==== [[X-ray]], usually a minimum of 2-views ====
* Generally, pre- and post-reduction X-rays are taken. Initial X-ray can confirm the dislocation and evaluate for any fractures. Post-reduction x-rays confirm successful joint alignment and can identify any injuries that may have been caused during the reduction procedure.<ref>{{cite journal | vauthors = Chong M, Karataglis D, Learmonth D | title = Survey of the management of acute traumatic first-time anterior shoulder dislocation among trauma clinicians in the UK | journal = Annals of the Royal College of Surgeons of England | volume = 88 | issue = 5 | pages = 454–458 | date = September 2006 | pmid = 17002849 | pmc = 1964698 | doi = 10.1308/003588406X117115 }}</ref>
* If initial X-rays are normal but additional injury is suspected, there may be a benefit of obtaining stress/weight-bearing views to look for injury to ligamentous structures and/or need for surgical intervention. One example is with [[Separated shoulder|AC joint separations.]]<ref>{{Cite web|url= https://radiopaedia.org/articles/acromioclavicular-injury |title=Acromioclavicular injury | work = Radiology Reference Article | publisher = Radiopaedia.org| vauthors = Gaillard F |language=en|access-date=21 February 2018}}</ref>

==== [[Ultrasound]] ====
* Ultrasound may be useful in an acute setting, and is a bedside test that can be performed in the Emergency Department. Ultrasound accuracy is dependent on user ability and experience. Ultrasound is nearly as effective as x-ray in detecting shoulder dislocations.<ref>{{cite journal | vauthors = Abbasi S, Molaie H, Hafezimoghadam P, Zare MA, Abbasi M, Rezai M, Farsi D | title = Diagnostic accuracy of ultrasonographic examination in the management of shoulder dislocation in the emergency department | journal = Annals of Emergency Medicine | volume = 62 | issue = 2 | pages = 170–175 | date = August 2013 | pmid = 23489654 | doi = 10.1016/j.annemergmed.2013.01.022 | doi-access = free }}</ref><ref>{{cite journal | vauthors = Gottlieb M, Patel D, Marks A, Peksa GD | title = Ultrasound for the diagnosis of shoulder dislocation and reduction: A systematic review and meta-analysis | journal = Academic Emergency Medicine | volume = 29 | issue = 8 | pages = 999–1007 | date = August 2022 | pmid = 35094451 | doi = 10.1111/acem.14454 }}</ref> Ultrasound may also have utility in diagnosing AC joint dislocations.<ref>{{cite journal | vauthors = Heers G, Hedtmann A | title = Correlation of ultrasonographic findings to Tossy's and Rockwood's classification of acromioclavicular joint injuries | journal = Ultrasound in Medicine & Biology | volume = 31 | issue = 6 | pages = 725–732 | date = June 2005 | pmid = 15936487 | doi = 10.1016/j.ultrasmedbio.2005.03.002 }}</ref>
* In infants <6 months of age with suspected [[Hip dysplasia|developmental dysplasia of the hip]] (congenital hip dislocation), ultrasound is the imaging study of choice. This is due to the lack of ossification at this age, which will not be apparent on x-rays.<ref>{{Cite web|url=https://radiopaedia.org/articles/developmental-dysplasia-of-the-hip |title=Developmental dysplasia of the hip | work = Radiology Reference Article | publisher = Radiopaedia.org | vauthors = Gaillard F |date=2 May 2008 |language=en|access-date=21 February 2018}}</ref>

==== Cross-sectional imaging ([[CT scan|CT]] or [[Magnetic resonance imaging|MRI]]) ====
* X-rays are generally sufficient in confirming a joint dislocation. However, additional imaging can be used to better define and evaluate abnormalities that may be missed or unclear on plain X-rays. CT and MRI are not routinely used for simple dislocation, however CT is useful in certain cases such as hip dislocation where an occult [[femoral neck fracture]] is suspected .<ref name="Wolters Kluwer_2020" /> CT angiogram may be used if vascular injury is suspected.<ref name="Wolters Kluwer_2020" /> In addition to improved visualization of bony abnormalities, MRI permits for a more detailed inspection of the joint-supporting structures in order to assess for ligamentous and other soft tissue injury.

=== Classification ===
Dislocations can either be full, referred to as luxation, or partial, referred to as subluxation. Simple dislocations are dislocations without an associated fracture, while complex dislocations have an associated fracture.<ref name="Wolters Kluwer_2020">{{Cite book |title=Rockwood and Green's fractures in adults |date=2020 |publisher=Wolters Kluwer |isbn=978-1-4963-8651-9 | veditors = Tornetta P |edition=9th |location=Philadelphia }}</ref> Depending on the type of joint involved (i.e. ball-and-socket, hinge), the dislocation can further be classified by anatomical position, such as an anterior hip dislocation.<ref name="Wolters Kluwer_2020" /> Joint dislocations are named based on the distal component in relation to the proximal one.<ref>{{Cite web |title=Introduction to Trauma X-ray - Dislocation injury |url=https://www.radiologymasterclass.co.uk/tutorials/musculoskeletal/trauma/trauma_x-ray_page6 |access-date=15 February 2018 |website=www.radiologymasterclass.co.uk |language=en-US}}</ref>

== Prevention ==
Preventing joint dislocations can be difficult since most are caused by an unexpected injury. If participating in activities such as contact sports, where there is a risk for dislocation, wearing appropriate protective equipment can be helpful. Similarly, avoiding positions that place the joint in a vulnerable position can reduce the risk of experiencing a dislocation. Strengthening the muscles surrounding joints can effectively reduce the risk of a joint dislocation and recurrent dislocations.<ref name="McMahon_2021">{{Cite book |title=Current Diagnosis & Treatment in Orthopedics |vauthors=McMahon PJ |publisher=McGraw-Hill Education |year=2021 |edition=6th}}</ref>

==Treatment==

=== Non-operative ===

==== Reduction/Repositioning ====
X-rays are taken to confirm the diagnosis and detect any associated fractures. A dislocation is easily seen on an X-ray.<ref name="Dias_1987">{{cite journal | vauthors = Dias JJ, Steingold RF, Richardson RA, Tesfayohannes B, Gregg PJ | title = The conservative treatment of acromioclavicular dislocation. Review after five years | journal = The Journal of Bone and Joint Surgery. British Volume | volume = 69 | issue = 5 | pages = 719–22 | date = November 1987 | pmid = 3680330 | doi = 10.1302/0301-620X.69B5.3680330 }}</ref> Once X-rays are taken, the joint is usually manipulated back into position. This can be a very painful process. This is typically done either in the [[emergency department]] under [[sedation]] or in an [[operating room]] under a [[general anaesthetic]].<ref name="pmid5483077">{{cite journal | vauthors = Holdsworth F | title = Fractures, dislocations, and fracture-dislocations of the spine | journal = The Journal of Bone and Joint Surgery. American Volume | volume = 52 | issue = 8 | pages = 1534–51 | date = December 1970 | pmid = 5483077 | doi = | url = }}</ref> A dislocated joint should be [[reduction (orthopedic surgery)|reduced]] into its normal position only by a trained medical professional. Trying to reduce a joint without any training could worsen the injury.<ref>{{cite journal | vauthors = Bankart AB | title = The pathology and treatment of recurrent dislocation of the shoulder-joint. | journal = Journal of British Surgery | date = July 1938 | volume = 26 | issue = 101 | pages = 23–29 | doi = 10.1002/bjs.18002610104 }}</ref>

It is important to reduce the joint as soon as possible. Delaying reduction can compromise the blood supply to the joint. This is especially true in the case of a dislocated ankle, due to the anatomy of the blood supply to the foot.<ref name="pmid11764423">{{cite journal | vauthors = Ganz R, Gill TJ, Gautier E, Ganz K, Krügel N, Berlemann U | title = Surgical dislocation of the adult hip a technique with full access to the femoral head and acetabulum without the risk of avascular necrosis | journal = The Journal of Bone and Joint Surgery. British Volume | volume = 83 | issue = 8 | pages = 1119–1124 | date = November 2001 | pmid = 11764423 | doi = 10.1302/0301-620x.83b8.11964 }}</ref> On field reduction is crucial for joint dislocations. As they are extremely common in sports events, managing them correctly at the game at the time of injury, can reduce long term issues. They require prompt evaluation, diagnosis, reduction, and post-reduction management before the person can be evaluated at a medical facility.<ref name="Skelley 246–255" /> After a dislocation, injured joints are usually held in place by a [[Splint (medicine)|splint]] (for straight joints like fingers and toes) or a [[bandage]] (for complex joints like shoulders).

==== Immobilization ====
Immobilization is a method of treatment to place the injured joint in a sling or in another immobilizing device in order to keep the joint stable.<ref name="Skelley 246–255"/> There is no significant difference in healing or long-term joint mobility between simple shoulder dislocations treated conservatively versus surgically.<ref>{{cite journal | vauthors = Taylor F, Sims M, Theis JC, Herbison GP | title = Interventions for treating acute elbow dislocations in adults | journal = The Cochrane Database of Systematic Reviews | volume = 2012 | issue = 4 | pages = CD007908 | date = April 2012 | pmid = 22513954 | pmc = 6465046 | doi = 10.1002/14651858.CD007908.pub2 | collaboration = Cochrane Bone, Joint and Muscle Trauma Group }}</ref> Shorter immobilization periods are encouraged, with the goal of return to increased range-of-motion activities as soon as possible.<ref>{{cite journal | vauthors = Barco R, Gonzalez-Escobar S, Acerboni-Flores F, Vaquero-Picado A | title = Acute elbow dislocation: a critical appraisal of the literature | journal = JSES International | volume = 7 | issue = 6 | pages = 2560–2564 | date = November 2023 | pmid = 37969505 | pmc = 10638560 | doi = 10.1016/j.jseint.2023.03.019 }}</ref><ref name="Breulmann_2024">{{cite journal | vauthors = Breulmann FL, Lappen S, Ehmann Y, Bischofreiter M, Lacheta L, Siebenlist S | title = Treatment strategies for simple elbow dislocation - a systematic review | journal = BMC Musculoskeletal Disorders | volume = 25 | issue = 1 | pages = 148 | date = February 2024 | pmid = 38365699 | pmc = 10874000 | doi = 10.1186/s12891-024-07260-0 | doi-access = free }}</ref> Shorter immobilization periods is linked to increased ranges of motion in some joints.<ref name="Breulmann_2024" />

==== Rehabilitation ====
Muscles, tendons and ligaments around the joint should be strengthened. This is usually done through a course of [[physical therapy]], which will also help reduce the chances of repeated dislocations of the same joint.<ref name="pmid14564258">{{cite journal | vauthors = Itoi E, Hatakeyama Y, Kido T, Sato T, Minagawa H, Wakabayashi I, Kobayashi M | title = A new method of immobilization after traumatic anterior dislocation of the shoulder: a preliminary study | journal = Journal of Shoulder and Elbow Surgery | volume = 12 | issue = 5 | pages = 413–5 | date = 2003 | pmid = 14564258 | doi = 10.1016/s1058-2746(03)00171-x }}</ref> Take the shoulder for example. The most common treatment method for a dislocation of the shoulder joint is exercise based management.<ref>{{cite journal | vauthors = Warby SA, Pizzari T, Ford JJ, Hahne AJ, Watson L | title = The effect of exercise-based management for multidirectional instability of the glenohumeral joint: a systematic review | journal = Journal of Shoulder and Elbow Surgery | volume = 23 | issue = 1 | pages = 128–142 | date = January 2014 | pmid = 24331125 | doi = 10.1016/j.jse.2013.08.006 | doi-access = free }}</ref> For shoulder instability, the therapeutic program depends on specific characteristics of the instability pattern, severity, recurrence and direction with adaptations made based on the needs of the patient. In general, the therapeutic program should focus on restoration of strength, normalization of range of motion and optimization of flexibility and muscular performance. Throughout all stages of the rehabilitation program, it is important to take all related joints and structures into consideration.<ref>{{cite journal | vauthors = Cools AM, Borms D, Castelein B, Vanderstukken F, Johansson FR | title = Evidence-based rehabilitation of athletes with glenohumeral instability | journal = Knee Surgery, Sports Traumatology, Arthroscopy | volume = 24 | issue = 2 | pages = 382–389 | date = February 2016 | pmid = 26704789 | doi = 10.1007/s00167-015-3940-x | s2cid = 21227767 }}</ref>

=== Operative ===
Surgery is often considered in extensive injuries or after failure of conservative management with strengthening exercises.<ref name="McMahon_2021" /> The need for surgery will depend on the location of the dislocation and the extent of the injury. Different methods and techniques exist to stabilize the joint with surgery. One method is through the use of [[Arthroscopy|arthroscopic surgery]].<ref name="Dias_1987" />

== Prognosis ==
Prognosis varies depending on the location and extent of the dislocation. The prognosis of a shoulder dislocation is dependent on various factors including age, strength, connective tissue health and severity of the injury causing the dislocation.<ref name="Wolters Kluwer_2020" /> There is a good prognosis in simple elbow dislocations in younger people. Older people report more pain and stiffness on average.<ref name="Wolters Kluwer_2020" /> Wrist dislocations are often difficult to manage due to the difficulty in healing the small bones in the wrist.<ref name="Wolters Kluwer_2020" /> Finger displacement towards the back of the hand is often irreducible due to associated injuries, while finger displacement towards the palm of the hand is more readily reducible.<ref name="Wolters Kluwer_2020" /> Overall, recovering from a joint dislocation can range from a few weeks to months, depending on the severity of the injury.<ref name="McMahon_2021" />

==Epidemiology==
Each joint in the body can be dislocated, however, there are common sites where most dislocations occur. The most common dislocated parts of the body are discussed as follows:
* [[Dislocated shoulder]]
** Anterior shoulder dislocation is the most common type of shoulder dislocation, accounting for at least 90% of shoulder dislocations.<ref name="Khiami S51–S57" /><ref>{{Cite book | vauthors = Breed M, Fitch RW |title=The Atlas of Emergency Medicine | edition = 5th |publisher=McGraw-Hill |year=2021 }}</ref> Anterior shoulder dislocations have a recurrence rate around 39%, with younger age at initial dislocation, male sex, and joint hyperlaxity being risk factors for increased recurrence.<ref name="Olds 913–922">{{cite journal | vauthors = Olds M, Ellis R, Donaldson K, Parmar P, Kersten P | title = Risk factors which predispose first-time traumatic anterior shoulder dislocations to recurrent instability in adults: a systematic review and meta-analysis | journal = British Journal of Sports Medicine | volume = 49 | issue = 14 | pages = 913–922 | date = July 2015 | pmid = 25900943 | pmc = 4687692 | doi = 10.1136/bjsports-2014-094342 }}</ref>
** The incidence rate of anterior shoulder dislocations is roughly 23.1 to 23.9 per 100,000 person-years.<ref name="Olds 913–922"/><ref name="Ponkilainen_2022">{{cite journal | vauthors = Ponkilainen V, Kuitunen I, Liukkonen R, Vaajala M, Reito A, Uimonen M | title = The incidence of musculoskeletal injuries: a systematic review and meta-analysis | journal = Bone & Joint Research | volume = 11 | issue = 11 | pages = 814–825 | date = November 2022 | pmid = 36374291 | pmc = 9680199 | doi = 10.1302/2046-3758.1111.BJR-2022-0181.R1 }}</ref> Young males have a higher incidence rate, roughly four times that of the overall population.<ref name="Olds 913–922"/>
** Recurrent anterior shoulder dislocations have a higher rate of labrum tears (Bankart lesion) and humerus fractures/dents (Hill-Sachs lesion) compared to initial dislocations.<ref>{{cite journal | vauthors = Rutgers C, Verweij LP, Priester-Vink S, van Deurzen DF, Maas M, van den Bekerom MP | title = Recurrence in traumatic anterior shoulder dislocations increases the prevalence of Hill-Sachs and Bankart lesions: a systematic review and meta-analysis | journal = Knee Surgery, Sports Traumatology, Arthroscopy | volume = 30 | issue = 6 | pages = 2130–2140 | date = June 2022 | pmid = 34988633 | pmc = 9165262 | doi = 10.1007/s00167-021-06847-7 }}</ref>
** Shoulder dislocations account for 45% of all dislocation visits to the emergency room.<ref name="Khiami S51–S57" />
* [[Elbow]]
** The incidence rate of elbow dislocations is 5 to 6 per 100,000 persons per year.<ref name="Wolters Kluwer_2020" /><ref name="Ponkilainen_2022" /><ref>{{cite journal | vauthors = Hackl M, Beyer F, Wegmann K, Leschinger T, Burkhart KJ, Müller LP | title = The treatment of simple elbow dislocation in adults | journal = Deutsches Ärzteblatt International | volume = 112 | issue = 18 | pages = 311–319 | date = May 2015 | pmid = 26037467 | pmc = 4455254 | doi = 10.3238/arztebl.2015.0311 }}</ref>
** Posterior dislocations are the most common type of elbow dislocations, comprising 90% of all elbow dislocations.<ref>{{cite web | url = http://emedicine.medscape.com/article/96758-overview | title = Elbow Dislocation | vauthors = Halstead ME, Bernhardt DT, Garry JP | veditors = Talavera F, Goitz HT, Young CC | work = Medscape | date = 16 November 2022}}</ref>
* [[Wrist]]
** Overall, injuries to the small bones and ligaments in the wrist are uncommon.<ref name="Heineman_2023" />
** Lunate dislocations are the most common.<ref name="Heineman_2023" />
* [[Finger]] 
** Interphalangeal (IP) or metacarpophalangeal (MCP) joint dislocations<ref>{{cite web | title = Reduction of Finger Dislocation | url = http://emedicine.medscape.com/article/109206-overview | vauthors = Polansky R, Kwon NS | veditors = Windle ML, Lovato LM, Schraga ED | work = Medscape | date = 27 June 2023 }}</ref>
*** In the United States, men are most likely to sustain a finger dislocation with an incidence rate of 17.8 per 100,000 person-years.<ref name="Golan_2016">{{cite journal | vauthors = Golan E, Kang KK, Culbertson M, Choueka J | title = The Epidemiology of Finger Dislocations Presenting for Emergency Care Within the United States | journal = Hand | volume = 11 | issue = 2 | pages = 192–196 | date = June 2016 | pmid = 27390562 | pmc = 4920528 | doi = 10.1177/1558944715627232 }}</ref> Women have an incidence rate of 4.65 per 100,000 person-years.<ref name="Golan_2016" /> The average age group that sustain a finger dislocation are between 15 and 19 years old.<ref name="Golan_2016" />
*** The most common dislocations are in the proximal interphalangeal (PIP) joints.<ref name="Borchers_2012" />
* [[Hip]]
** Posterior and anterior [[hip dislocation]]
*** Anterior dislocations are less common than posterior dislocations. 10% of all dislocations are anterior and this is broken down into superior and inferior types.<ref name="Clegg_2010">{{cite journal | vauthors = Clegg TE, Roberts CS, Greene JW, Prather BA | title = Hip dislocations--epidemiology, treatment, and outcomes | journal = Injury | volume = 41 | issue = 4 | pages = 329–334 | date = April 2010 | pmid = 19796765 | doi = 10.1016/j.injury.2009.08.007 }}</ref> Superior dislocations account for 10% of all anterior dislocations, and inferior dislocations account for 90%.<ref name="Clegg_2010" /> 16-40 year old males are more likely to receive dislocations due to a car accident.<ref name="Clegg_2010" /> 
*** When an individual receives a hip dislocation, there is an incidence rate of 95% that they will receive an injury to another part of their body as well.<ref name="Clegg_2010" /> 
*** 46–84% of hip dislocations occur secondary to traffic accidents, the remaining percentage is due based on falls, industrial accidents or sporting injury.<ref name="Olds 913–922" />
* [[Knee]]
** The majority of knee dislocations (64.5%) are caused by trauma to the knee, with more than half caused by car and motorcycle accidents.<ref name="Randall_2024">{{cite journal | vauthors = Randall ZD, Strok MJ, Mazzola JW, Agrawal R, Yaeger LH, Berkes MB | title = The known and unknown reality of knee dislocations: A systematic review | journal = Injury | volume = 55 | issue = 11 | pages = 111904 | date = November 2024 | pmid = 39357194 | doi = 10.1016/j.injury.2024.111904 | doi-access = free }}</ref>
** The incidence rate of initial patellar dislocations is roughly 32.8 per 100,000 person years.<ref name="Ponkilainen_2022" />
** Nearly 41% of knee dislocations have an associated fracture, with the majority of these fractures in one of the legs.<ref name="Randall_2024" />
** Nerve injury occurs in about 15.3% of knee dislocations, while major artery injury occurs in 7.8% of knee dislocations.<ref name="Randall_2024" />
** More than half (53.5%) of knee dislocations have an associated torn meniscus.<ref name="Randall_2024" />
** Quadriceps tendon rupture occurs up to 13.1% of the time, and patellar tendon rupture occurs 6.8% of the time.<ref name="Randall_2024" />
* Foot and Ankle
** A [[lisfranc injury]] is a dislocation or fracture-dislocation injury at the tarsometatarsal joints.
** [[Subtalar joint|A subtalar]] dislocation, or [[Talocalcaneonavicular joint|talocalcaneonavicular]] dislocation, is a simultaneous dislocation of the talar joints at the talocalcaneal and talonavicular levels.<ref>{{cite journal | vauthors = Ruhlmann F, Poujardieu C, Vernois J, Gayet LE | title = Isolated Acute Traumatic Subtalar Dislocations: Review of 13 Cases at a Mean Follow-Up of 6 Years and Literature Review | journal = The Journal of Foot and Ankle Surgery | volume = 56 | issue = 1 | pages = 201–207 | date = 2017 | pmid = 26947001 | doi = 10.1053/j.jfas.2016.01.044 | type = Review | s2cid = 31290747 }}</ref><ref>{{cite journal | vauthors = García-Regal J, Centeno-Ruano AJ | title = [Talocalcaneonavicular dislocation without associated fractures] | language = es | journal = Acta Ortopedica Mexicana | volume = 27 | issue = 3 | pages = 201–204 | date = 2013 | pmid = 24707608 | type = Review }}</ref> 
** Subtalar dislocations without associated fractures represent about 1% of all traumatic injuries of the foot. They represent 1-2% of all dislocations and are caused by high energy trauma.<ref>{{cite journal | vauthors = Prada-Cañizares A, Auñón-Martín I, ((Vilá Y Rico J)), Pretell-Mazzini J | title = Subtalar dislocation: management and prognosis for an uncommon orthopaedic condition | journal = International Orthopaedics | volume = 40 | issue = 5 | pages = 999–1007 | date = May 2016 | pmid = 26208589 | doi = 10.1007/s00264-015-2910-8 | type = Review | s2cid = 6090499 }}</ref>
** A total talar dislocation has high rates of complications but is rare.<ref>{{cite book| vauthors = Foy MA, Fagg PS |title=Medicolegal Reporting in Orthopaedic Trauma E-Book|url=https://books.google.com/books?id=_ajRAQAAQBAJ&pg=PA320|date=5 December 2011|publisher=Elsevier Health Sciences|isbn=978-0-7020-4886-9|pages=320–}}</ref><ref>For a graphic representation of displacements that may lead to a total talar dislocation see: {{cite book| vauthors = Bucholz RW |title=Rockwood and Green's Fractures in Adults: Two Volumes Plus Integrated Content Website (Rockwood, Green, and Wilkins' Fractures)|url=https://books.google.com/books?id=OhVSFNEIanIC&pg=PA2061|date=29 March 2012|publisher=Lippincott Williams & Wilkins|isbn=978-1-4511-6144-1|pages=2061}}</ref>
** Ankle sprains primarily occur as a result of tearing the ATFL (anterior talofibular ligament) in the talocrural joint. The ATFL tears most easily when the foot is in plantarflexion and inversion. Weakening of the ligaments can put the ankle at risk for dislocation.<ref>{{cite journal | vauthors = Ringleb SI, Dhakal A, Anderson CD, Bawab S, Paranjape R | title = Effects of lateral ligament sectioning on the stability of the ankle and subtalar joint | journal = Journal of Orthopaedic Research | volume = 29 | issue = 10 | pages = 1459–1464 | date = October 2011 | pmid = 21445995 | doi = 10.1002/jor.21407 | doi-access = free }}</ref>
** An ankle dislocation without fracture is rare, due to the strength of ligaments surrounding the ankle.<ref name="pmid28826653">{{cite journal | vauthors = Wight L, Owen D, Goldbloom D, Knupp M | title = Pure Ankle Dislocation: A systematic review of the literature and estimation of incidence | journal = Injury | volume = 48 | issue = 10 | pages = 2027–2034 | date = October 2017 | pmid = 28826653 | doi = 10.1016/j.injury.2017.08.011 | type = Review }}</ref>

==Gallery==
<gallery mode="packed" heights="220">
File:Dislocated finger.jpg| Dislocation of the left index finger
File:Pinkie.jpg|[[Radiograph]] of right fifth [[phalanx bone]] dislocation
File:Dislocated finger x-ray.JPG|[[Radiograph]] of left index finger dislocation
File:Reduce dislocated spine, c. 1300.jpg|Depiction of reduction of a dislocated spine, ca. 1300
File:MCCdislocation.PNG|Dislocation of the carpo-metacarpal joint.
File:Dislocated Finger XRay.png|Radiograph of right fifth phalanx dislocation resulting from bicycle accident
File:Dislocated Finger.JPG|Right fifth phalanx dislocation resulting from bicycle accident
File:Lightbulb sign - posterior shoulder dislocation - Roe vor und nach Reposition 001.jpg|Shoulder dislocation before (left) and after (right) being reduced
File:X-ray of ventral dislocation of the radial head with calcification of annular ligament.jpg|[[Projectional radiography|X-ray]] of ventral dislocation of the radial head. There is calcification of annular ligament, which can be seen as early as 2 weeks after injury.<ref name="pmid1604339">{{cite journal | vauthors = Earwaker J | title = Posttraumatic calcification of the annular ligament of the radius | journal = Skeletal Radiology | volume = 21 | issue = 3 | pages = 149–154 | year = 1992 | pmid = 1604339 | doi = 10.1007/BF00242127 | s2cid = 43615869 }}</ref>
File:Radiographie d’une luxation postérieur du coude gauche sans fracture.jpg|[[X-ray]] of left [[elbow]] posterior joint dislocation without [[fracture]]
</gallery>

== See also ==
* [[Buddy wrapping]]
* [[Major trauma]]
* [[Physical therapy]]
* [[Projectional radiography]]
* [[Spondylolisthesis|Listhesis, olisthesis, or olisthy]]

== References ==
{{Reflist}}

== External links ==
{{Medical resources
|  DiseasesDB     =
|  ICD10          = {{ICD10|T|14|3|t|08}}
|  ICD9           = {{ICD9|830}}-{{ICD9|848}}
|  ICDO           =
|  OMIM           =
|  MedlinePlus    = 000014
|  eMedicineSubj  =
|  eMedicineTopic =
|  MeshID         = D004204
}}
{{Commons category|Luxations}}
{{Dislocations, sprains and strains}}
{{Trauma |state=autocollapse}} 

{{Authority control}}

{{DEFAULTSORT:Joint Dislocation}}
[[Category:Contortion]]
[[Category:Joints]]
[[Category:Dislocations, sprains and strains]]
[[Category:Emergency medical procedures]]