Types of joint injuries and principles of treatment

Distortion (sprain)
Distortion (sprain) occurs through indirect action or direct violence when the physiological range of motion in a given joint is exceeded.

Clinical picture

 * partial rupture or distension of the capsule or ligaments. It can also be hemarthroses
 * the joint remains stable
 * soreness, swelling, restriction of movement, hematoma

Therapy

 * puncture a larger effusion, evacuate the hepatoma and flush the cavity with cold saline or mesocaine (in case of severe pain)
 * immobilisation, according to disability, lighten the joint, give NOA, ice
 * we can indicate arthroscopy for the knee

Subluxation
A subluxation is an incomplete dislocation. It is caused by more violence than distortion. The bones are in a so-called subluxation position, when the joint surfaces only partially touch.

Clinical picture

 * Injury to the capsule and ligaments is greater than with distortion.
 * The joint is slightly unstable, but spontaneous reduction often occurs.

Therapy

 * Rigid immobilisation is necessary for a period of 3–6 weeks.
 * Relief, icing, NOA
 * In more difficult cases – operative revision with ligament suture.

Luxation
Luxation (dislocation) occurs in case of significant force on the joint (possibly less force in case of predisposition), a serious disorder of congruence occurs. Reduction can be spontaneous, but usually the joint is dislocated.



According to the mechanism of formation, we distinguish sprains:
 * Traumatic – caused by sudden and strong violence that breaks the stabilizing fibrous structures of the joint.
 * Habitual – arises as a result of primary or secondary functional disorders or anatomical structure of the joint.
 * Pathological – in case of long-term changes in the joint (damage of the joint surfaces during paralysis, loosening of the joint capsule during chronic inflammation).
 * Congenital - basis in the presence of congenital dysplasia (hip).

Clinical picture

 * swelling, hematoma, significant pain
 * we monitor innervation, blood supply to the periphery, momentum
 * we are investigating whether it is a dislocation fracture on the X-ray

Therapy

 * perform under local or general anesthesia
 * after repositioning, we check stability and detect damage to soft tissues
 * immobilize the joint
 * subsequent rehabilitation is important

Related articles

 * Injury
 * Regional anesthesia, blockades
 * [[General anesthesia]