Urgent care centers are designed to treat acute, non-life-threatening injuries, and a joint dislocation often falls into this category. The ability of an urgent care facility to treat a dislocation depends on the specific joint involved and the presence of complications. While facilities are equipped to manage simple dislocations, strict safety protocols require immediate transfer to an emergency room for more complex cases.
Diagnosis and Initial Triage at Urgent Care
A patient arriving at urgent care with a suspected dislocation undergoes a thorough initial assessment. The provider performs a physical examination to check for visible deformity, swelling, and the patient’s ability to move the joint. They also assess for signs of nerve or blood vessel compromise, which helps determine the initial stability and complexity of the injury.
The diagnostic process involves medical imaging, as many urgent care centers have on-site X-ray capabilities. X-rays confirm the presence of a dislocation and rule out an associated fracture, which would complicate the treatment plan. The combination of the physical exam and the X-ray image is used to triage the injury.
If the provider determines the injury is a simple dislocation, such as a finger, toe, or a straightforward shoulder injury, they can proceed with management. If the injury is high-risk or too complex for the facility’s resources, the patient is stabilized for immediate transfer. This ensures treatment remains within the facility’s scope of practice and prioritizes patient safety.
When an Emergency Room is Necessary
Certain characteristics immediately elevate an injury beyond the scope of a typical urgent care center, necessitating an emergency room visit. An open dislocation, where the bone has broken through the skin, requires immediate surgical consultation and a sterile environment to prevent severe infection. Any sign of neurovascular compromise, such as numbness, tingling, or a loss of pulse below the injury site, indicates potential damage to nerves or arteries.
Dislocations involving large, high-risk joints also require the emergency room. For instance, a hip or knee dislocation carries a high risk of vascular injury, such as to the popliteal artery in the knee, which can lead to limb-threatening complications. These complex dislocations often require deeper procedural sedation, specialized imaging like CT scans, or the immediate availability of an orthopedic surgeon. Urgent care staff recognize these “red flags” and stabilize the limb before arranging for rapid transfer via emergency medical services.
Reduction and Post-Treatment Procedures
For simple dislocations appropriate for urgent care management, the next step is reduction—manually maneuvering the bone back into the joint socket. Because this procedure is painful, the provider first administers pain management, which may involve local anesthetic injections or moderate procedural sedation. Relaxing the surrounding muscles is paramount, as muscle spasm can make the reduction significantly more difficult and increase the risk of tissue damage.
Once the patient is comfortable, the provider uses a specific manual technique, such as traction-countertraction for a shoulder, to gently realign the joint. Following successful reduction, a second X-ray is immediately performed to confirm the bones are properly positioned and that no new fracture occurred. The joint is then immobilized using a splint, sling, or cast to allow the stretched ligaments and joint capsule to heal and prevent re-dislocation. Before discharge, the patient receives detailed instructions on pain control, monitoring for complications, and scheduling follow-up care with an orthopedic specialist.