Joint injuries

Common injuries can be classified as:

• fracture/dislocation. Joints commonly injured are:

• interphalangeal (IP) joints,

• metacarpophalangeal (MCP) joint of thumb,

Figure 22.16. Fracture-dislocation of the cervical spine (C6/C7).

Figure 22.15. Osteoarthritis of the hip.

• spinal facet joint (cervical) (Fig. 22.16). The history should elicit:

• mechanism of injury;

• associated injuries;

• previous injury to affected joint and duration since;

• history of generalized joint and other joint laxity;

• family history of joint instability;

• previous treatment regimens, including hospitalization;

• effect on occupation, domestic and social activities.

The examination should include early and adequate evaluation of:

• remainder of the affected limb;

• neurovascular status;

• overlying skin/soft tissues;

• associated injuries, for example if hip joint dislocation, check posterior cruciate ligament (PCL) of ipsilateral knee.

One should also:

• Document any neurovascular deficits prior to attempted reduction as the procedure for reduction may result in neurovascular injury.

Figure 22.16. Fracture-dislocation of the cervical spine (C6/C7).

Document any associated injuries/fracture prior to reduction as manipulation can result in fracture of involved bones, for example fracture of surgical neck of humerus with reduction of shoulder dislocation.

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