Luxation

Mechanism

The most frequent mechanism is a clumsy movement, or a request external of a member like a key of arm ( armlock ). The member plays a part of lever which steps up the effort on the articulation.

Diagnosis

The first elements being able to make think of a luxation are:

the mechanism : shock, falls;
the pain , abruptly appeared and located;
the functional impotence : it is painful or impossible to carry out certain movements;
the deformation : dissymmetry of the articulations (the articulation of left does not resemble that of right-hand side);
previous of luxation: when an articulation was luxated, it is weakened and thus the appearance of another luxation at the same place is probable.

These signs are not specific and can also indicate a distorsion or a Fracture, but an attentive clinical examination will make the difference. Contrary, certain luxations present Symptôme S attenuated, for example in the case of a person having flexible articulations (child, repetition of luxation).

The only examination which can indicate without ambiguity if there is luxation or not is the Radiographie.

Consequences

Luxation is a displacement or a spacing of two articular surfaces, accompanied by a tear of the ligaments, which can go in the extreme cases until their rupture or with an osseous wrenching. There is thus an embrittlement of the articulation. In the same way, luxation can involve an osseous fracture (example: fracture glene in the luxation scapulo-humérale) which will weaken also the articulation.

Moreover, the displacement of the articulation can grip a Nerf or a Blood-vessel, which can cause neurological problems with the members (in particular at the ends) and of blood food (Ischémie). For the members, there will be an indication of such problems if the person present:

of the disorders of the sensitivity (feeling of swarming, loss of sensitivity, feeling of electric shock) or of the motricity of the ends;
a distal pulse (radial or pedal) dissymmetrical, difficult to feel on a side even absent, palenesses and coldnesses with the fingers or toes.

In certain cases, a not detected and thus nonreduced luxation will have as a consequence, on the long run, an articular rebuilding: a new articulation will be created on the new zone of articular contact in the form of an osseous digging, an approximate mobility is then found. This type of osseous rearrangement is generally observed on luxations of the shoulder and the Hanche.

Treatment

Luxation is a problem which must be treated by a doctor, it is an urgency.

While waiting for the helps

It is necessary to advise with the victim not to move, and prohibit any person from trying to move the victim except vital urgency (emergency Dégagement). If the person falls unconscious, it will have to be turned in side Position of safety on the wounded side.

Prompt help

The Raising and transport (Brancardage) must be carried out with much care by avoiding the jolts.

In the case of a luxation of the shoulder, one will pose a diagonal scarf, or one will put a linen under the armpit to try to support the weight of the arm which draws on the shoulder. In the other cases, the immobilization will be done with the Matelas immobilisator with depression.

Medical care

Reduction, application. It is very important to use radiographies in order to make sure that luxation is not accompanied by a fracture. Generally, a luxation of the shoulder asks for 5 weeks of immobilization of the articulation via a Attelle standard scarf or waistcoat GCI. treatments of luxation

under general ansesthesy
reduction of luxation by making refranchire gently with the extrimitè luxèe the chemain traversed at the time of the accident
immobilization of the articulation in position of relàchement hang 10 to 21 days

Particular cases

Congenital luxation of the hip

It touches the girls in the proportion from six to eight for a boy. It particularly affects the Lapons, the Amerindian S Navajos, the Kabyles, the Inuits and the Bigouden S.

This anomaly of the positioning of the head of the femur in cotyle is handicapping if she is not diagnosed by an echography at the one month age by an attentive pediatrist then treated by maintaining the lower extremities of the baby bent, thighs drawn aside, by means of langeage adapted and tightened, or of a cushion of Becker or a harness.

The bearing can regulate the problem of luxation of the hip in the child if pathology is not too severe and that the parents of children reached take their role of carrier to the serious one.

Luxation of the articulation temporo-mandibulaire (ATM)

There exist 2 types of luxation of the ATM:

luxation of the intervertebral discs.

It is a functional deterioration of the ATM, characterized by the dislocation of the complex disco music-condylien.

luxation condylienne or luxation temporo-mandibulaire

It is a deterioration of the relationship between temporal eminence and the condyle mandibulaire.

The reduction is done thanks to the Manœuvre of Nélaton.

See too

Key articular in martial arts

External bonds

Luxation of the shoulder: catch of load in the winter sports resorts, the General practitioner n°2006, February 15th 2000

Bearing of the babies and congenital Luxation of the hip, Association To carry its Baby

Orthopedic Layers, infos on the dysplasy of the hip

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