Is It Possible to Have a Dislocation Without Pain? Your Injury

Uncertain if there is a dislocation?

Hello, last month I was in a car accident and was taken to the emergency room.
After an X-ray, I was informed that I had a hairline fracture, but the doctor assessed that it could heal on its own.
A month later, I returned for another X-ray and was told there might be a dislocation.
The doctor was uncertain because the wound on the right side of my wrist is quite deep and has undergone skin grafting, which has resulted in a reduced range of motion in my hand and tighter new skin.
During the X-ray, my positioning may not have been optimal, and the doctor mentioned that the issues with the skin graft could have affected the imaging angle, making it appear as if there was a dislocation.
I was advised to return next month for further evaluation.

I would like to ask, last month's X-ray only showed a hairline fracture of less than one centimeter and did not indicate any dislocation.
Today, however, I was informed that there might be a dislocation, but I do not experience any pain or discomfort when moving my hand.
Is it really possible that I have a dislocation under these circumstances? After all, I have been resting both at the hospital and at home, making it difficult for a dislocation to occur.

Ms. Chen, 10~19 year old female. Ask Date: 2021/08/18

Dr. Zhan Xian reply Orthopedics

Hello, without physical examination and imaging studies, it is not possible to make an assessment.

Reply Date: 2021/08/18

More Info

It is indeed possible to experience a dislocation without significant pain, although this is relatively uncommon. Dislocations typically occur when the bones in a joint are forced out of their normal positions, which can lead to pain, swelling, and limited mobility. However, there are several factors that can contribute to a situation where a dislocation might not be accompanied by the expected level of pain.

1. Type of Dislocation: Some dislocations, particularly partial dislocations (also known as subluxations), may not cause severe pain. In these cases, the joint may still be partially aligned, leading to less discomfort.

2. Individual Pain Tolerance: Pain perception varies significantly among individuals. Some people may have a higher pain threshold and might not feel the pain as intensely as others would in the same situation.

3. Accompanying Injuries: If there are other injuries present, such as a fracture or soft tissue damage, the pain from those injuries might overshadow the pain from a dislocation. In your case, the presence of a skin graft and the associated tightness may also alter your pain perception.

4. Nerve Damage: In some cases, if the nerves around the joint are damaged during the injury, this can lead to a reduced sensation of pain in the affected area, even if a dislocation has occurred.

5. Inflammation and Swelling: The body’s inflammatory response can sometimes mask pain. If there is significant swelling or bruising, it might be difficult to assess the level of pain accurately.

Given your situation, where you have a history of a wrist injury with a skin graft and have been told there might be a dislocation, it's crucial to follow up with your healthcare provider. The fact that you are experiencing limited mobility and have had a previous injury complicates the assessment.

Recommendations:
1. Follow-Up Imaging: Since the initial X-ray did not show a dislocation, and the subsequent assessment suggested a possible dislocation, it would be prudent to get follow-up imaging. An MRI or a repeat X-ray, possibly with a different positioning technique, may provide clearer insights into the state of your wrist.

2. Physical Examination: A thorough physical examination by an orthopedic specialist can help determine the stability of the joint and whether there is indeed a dislocation or other underlying issues.

3. Monitoring Symptoms: Keep track of any changes in your symptoms. If you start to experience pain, swelling, or changes in mobility, it is essential to report these to your doctor immediately.

4. Rehabilitation: If a dislocation is confirmed, rehabilitation exercises may be necessary to restore function and strength to the wrist. This is especially important after a skin graft, as the area may be more susceptible to stiffness and reduced range of motion.

5. Pain Management: Even if you are not currently experiencing pain, it is wise to discuss pain management strategies with your healthcare provider, especially if you anticipate discomfort during rehabilitation.

In conclusion, while it is possible to have a dislocation without pain, it is essential to have a thorough evaluation to ensure proper diagnosis and treatment. Your healthcare provider will be able to guide you through the next steps based on the findings from your follow-up appointments.

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