Subluxation

For the Chiropractic concept of subluxation, see Vertebral subluxation.

A subluxation may have different meanings, depending on the medical specialty involved. It implies the presence of an incomplete or partial dislocation of a joint or organ.[lower-alpha 1] The World Health Organization (WHO) defines both the medical subluxation and the chiropractic subluxation. It contrasts the two and states in a footnote that a medical subluxation is a "significant structural displacement, and therefore visible on static imaging studies."[2]

Orthopedics

An orthopedic subluxation of any joint will sometimes require medical attention to help relocate or reduce the joint. Nursemaid's elbow is the subluxation of the head of the radius from the annular ligament. Other joints that are prone to subluxations are the shoulders, fingers, kneecaps, ribs, wrists, ankles, and hips affected by hip dysplasia. A spinal subluxation can sometimes impinge on spinal nerve roots, causing symptoms in the areas served by those roots. In the spine, such a displacement may be caused by a fracture, spondylolisthesis, rheumatoid arthritis,[3] severe osteoarthritis, falls, accidents, and other traumas. People with frequent subluxations are known as hypermobile. This is common in Ehlers-Danlos Syndrome.

Ophthalmology

An ophthalmologic subluxation is called ectopia lentis, an ocular condition characterized by a displaced or malpositioned lens within the eye.[4] Subluxated lenses are frequently found in those who have had ocular trauma and those with certain systemic disorders, such as Marfan syndrome, Ehlers–Danlos syndrome, Loeys-Dietz syndrome and homocystinuria. Some subluxated lenses may require removal, as in the case of those that float freely or those that have opacified to form cataracts.

Dentistry

Main article: Dental subluxation

A dental subluxation is a traumatic injury in which the tooth has increased mobility but has not been displaced from the mandible or maxilla. This is a common condition and one of the most common dental traumatic disorders.[5] Dental subluxation is a non-dental-urgency condition, i.e., unlikely to result in significant morbidity if not seen within 24 hours by a dentist,[6] and usually treated conservatively: good oral hygiene with 0.12% chlorhexidine gluconate mouthwash, a soft and cold diet, and avoidance of smoking for several days.[6] In painful situations, a temporary splinting of the injured teeth may relieve the pain.[7]

Subluxation may also occur in the mandible from the articular groove of the temporal bone.[8] The mandible can dislocate in the anterior, posterior, lateral, or superior position. Description of the dislocation is based on the location of the condyle in comparison to the temporal articular groove.[9]

Notes

  1. ↑ Definition: subluxation n : partial displacement of a joint or organ[1]

References

  1. ↑ "Webster's Revised Unabridged Dictionary (1913)". Retrieved 12 March 2013.
  2. ↑ WHO guidelines on basic training and safety in chiropractic (PDF). Geneva: WHO. 2005. ISBN 9241593717. Retrieved 12 March 2013.(p4 including footnote)
  3. ↑ Calleja, Michele (25 May 2011). Chew, Felix S, ed. "Rheumatoid Arthritis Spine Imaging". Medscape reference. WebMD LLC. Retrieved 12 March 2013.
  4. ↑ Eifrig, Charles W (22 July 2011). Roy Sr, Hampton, ed. "Ectopia Lentis". Medscape reference. WebMD LLC. Retrieved 12 March 2013.
  5. ↑ Zadik Y, Levin L (February 2009). "Oral and facial trauma among paratroopers in the Israel Defense Forces". Dent Traumatol 25 (1): 100–102. doi:10.1111/j.1600-9657.2008.00719.x. PMID 19208020.
  6. 1 2 Zadik Y (December 2008). "Algorithm of first-aid management of dental trauma for medics and corpsmen". Dent Traumatol 24 (6): 698–701. doi:10.1111/j.1600-9657.2008.00649.x. PMID 19021668.
  7. ↑ Flores MT, Andersson L, Andreasen JO, et al. The International Association of Dental Traumatology (April 2007). "Guidelines for the management of traumatic dental injuries. I. Fractures and luxations of permanent teeth". Dent Traumatol 23 (2): 66–71. doi:10.1111/j.1600-9657.2007.00592.x. PMID 17367451.
  8. ↑ Chaudhry, Meher (19 April 2012). Kulkarni, Rick, ed. "Mandible dislocation". Medscape Reference. WebMD LLC. Retrieved 12 March 2013.
  9. ↑ Haddon, Robert & Peacock IV, W Franklin (2003). "240". In Tintinalli, Judith E; Kelen, Gabor D & Stapczynski, J Stephan. Face and Jaw Emergencies. Emergency Medicine: A Comprehensive Study Guide (6th ed.). McGraw-Hill. pp. 1471–1476. ISBN 978-0071388757.
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