A dislocation results when the end of a bone is moved from its normal articular
position. The ligaments that hold the ends of the bones together may be torn. Other
tissues surrounding the joint (the joint capsule) may also be injured (refer back to
figure 1-2). Joints frequently affected include the shoulder, elbow, fingers, hips, and
a. Signs and Symptoms. A dislocation results in a deformed appearance due
to the bone being out of its normal position. A dislocation also causes pain and/or a
feeling of pressure over the joint. The region around the joint usually swells and is
tender. The casualty may not be able to move the joint (the joint is "locked"). If the end
of the dislocated bone is pressing on a nerve or blood vessel, the casualty may
experience numbness or paralysis distal to (below) the injury.
Do not ask the casualty to move the injured body part in order to test for
a locked joint or pain.
b. Treatment. Treat a dislocation as though it were a closed fracture.
(1) Immobilize the joint in the position in which the joint was found. Do not
attempt to straighten or realign the bones.
(2) Reduce the swelling by elevating the joint and applying cold (a cold pack
or ice compress, if available) to the joint for the first 24 hours after the musculoskeletal
injury. After 24 hours, heat or warm soaks should be used to facilitate circulatory
perfusion to the injured area.
(3) Check for pulse, strength, and sensation distal to the injury. If there is
no pulse distal to the injury, attempt to restore blood circulation by gentle manipulation.
If there is still no pulse, evacuate the casualty to a medical treatment facility as quickly
A sprain results when the ligaments connecting two bones are stretched or torn.
The other tissues that surround the joint may also be damaged. A sprain usually results
when a joint is suddenly twisted beyond its normal range of motion. Skiing accidents
often result in sprains. Sprains are most common in the knees and ankles. A sprain
can result from a partial or temporary dislocation in which the bones resume their
normal position following the injury. A sprain may produce as much damage as a