11.7
Joint and Tendon Injuries
Malawi Standard Treatment Guidelines, 6th Edition, 2023. Chapter 11, Musculoskeletal Disorders.
Clinical Description
- Usually due to sports injuries, road accidents, assault and occupational hazards
- Classification
- Dislocations\Fracture-dislocations\subluxations
- Haemarthrosis: as a complication of severe injury or spontaneously in haemophilia
- Ligamentous and tendon injuries: occur following twisting, traction or bending forces
Signs and Symptoms
- Pain, swelling, loss of function, deformity, crepitus (if there is an associated fracture) and neurovascular complications.
- Commonly shoulder, hip, elbow and ankle.
Investigations
- Diagnosis is made after clinical examination and radiology.
- Always look for neurovascular complications.
Treatment
- Treatment of dislocation should be urgent because of irreversible damage to cartilage and neurovascular structures; and to relive pain.
- Urgent reduction and immobilization.
- Check X−ray and refer if reduction is not congruent.
- In children suspect epiphyseal/growth plate injuries and refer to surgeons
- Period of immobilization is dependent on joint stability and associated injuries
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