Editing Subluxation

{{Short description|Partial dislocation of a joint or organ}}
{{For|the concept of a [[chiropractic]] subluxation|vertebral subluxation}}
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A '''subluxation''' is an incomplete or partial [[dislocation (medicine)|dislocation]] of a [[Joint dislocation|joint]] or [[organ (anatomy)|organ]].<ref name="Merriam-Webster">{{cite web | title=Definition of SUBLUXATION | website=Merriam-Webster | url=https://www.merriam-webster.com/dictionary/subluxation | access-date=January 4, 2018}}</ref> According to the [[World Health Organization]], a subluxation is a "significant structural displacement" and is therefore visible on static imaging studies, such as [[X-ray]]s.<ref>{{cite journal |last1=Schwarz |first1=N. |title=The fate of missed atlanto-axial rotatory subluxation in children |journal=Archives of Orthopaedic and Trauma Surgery |date=April 1998 |volume=117 |issue=4–5 |pages=288–289 |doi=10.1007/s004020050249 |pmid=9581264 }}</ref><ref>{{cite journal |last1=Laiho |first1=K |last2=Soini |first2=I |last3=Kautiainen |first3=H |last4=Kauppi |first4=M |title=Can we rely on magnetic resonance imaging when evaluating unstable atlantoaxial subluxation? |journal=Annals of the Rheumatic Diseases |date=March 2003 |volume=62 |issue=3 |pages=254–256 |doi=10.1136/ard.62.3.254 |pmid=12594114 |pmc=1754452 |doi-access=free }}</ref><ref>{{cite journal |last1=Garth |first1=William P. |last2=Allman |first2=Fred L. |last3=Armstrong |first3=William S. |title=Occult anterior subluxations of the shoulder in noncontact sports |journal=The American Journal of Sports Medicine |date=November 1987 |volume=15 |issue=6 |pages=579–585 |doi=10.1177/036354658701500610 |pmid=3425785 }}</ref> Unlike real subluxations, the [[pseudoscience|pseudoscientific]] concept of a [[chiropractic]] "[[vertebral subluxation]]" may or may not be visible on x-rays.

The term is used in the fields of [[medicine]], [[dentistry]], and chiropractic. There is no scientific evidence for the existence of chiropractic subluxations or proof they or their treatment have any effects on health.<!-- See section for the references. -->

== Medical ==
=== Joints ===

[[File:Metacarpophalangeal subluxation.svg|thumb| X-ray showing [[Metacarpophalangeal joint|metacarpophalangeal]] subluxation of the thumb of a 71-year-old woman due to [[trapeziometacarpal osteoarthritis]]]]
A subluxation of a [[joint]] is where a connecting bone is partially out of the joint.<ref>[https://books.google.com/books?id=UjKPBAAAQBAJ&pg=PA107 Page 107] in: {{cite book|title=Medical Terminology & Anatomy for ICD-10 Coding|author=Betsy J. Shiland|edition=2|publisher=Elsevier Health Sciences|year=2014|isbn=9780323290784}}</ref> In contrast to a luxation, which is a complete separation of the joint, a subluxation often returns to its normal position without additional help from a [[health professional]].<ref>[https://books.google.com/books?id=NDb1OOK8ZsoC&pg=PA63 page 63] in: {{cite book|title=The Practical Guide to Athletic Training|author=Ted Eaves|publisher=Jones & Bartlett Publishers|year=2011|isbn=9781449662684}}</ref> An example of a joint subluxation is a [[nursemaid's elbow]], which is the subluxation of the head of the [[Radius (bone)|radius]] from the [[annular ligament of radius|annular ligament]]. Other joints that are prone to subluxations are the [[shoulder]]s, [[finger]]s, [[patella|kneecaps]], ribs, wrists, ankles, and hips affected by [[hip dysplasia (human)|hip dysplasia]]. A spinal subluxation is visible on X-rays and 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]],<ref>{{cite web | url= http://emedicine.medscape.com/article/398955-overview | title= Rheumatoid Arthritis Spine Imaging | first= Michele | last= Calleja | editor-first= Felix S | editor-last= Chew | work= Medscape reference | publisher= WebMD LLC | date=May 25, 2011 | access-date=March 12, 2013 }}</ref> severe [[osteoarthritis]], falls, accidents and other traumas.

=== Ophthalmology ===

A subluxation of the [[lens (anatomy)|lens]] within the [[Human eye|eye]] is called [[ectopia lentis]], wherein it is displaced or malpositioned.<ref>{{cite web | url= http://emedicine.medscape.com/article/1211159-overview | title= Ectopia Lentis | first= Charles W | last= Eifrig | editor-first= Hampton | editor-last= Roy Sr | work=  Medscape | publisher= WebMD LLC | date=July 22, 2011 | access-date=March 12, 2013 }}</ref> 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 [[cataract]]s.{{citation needed|date=October 2020}}

== Dental ==

{{Main|Dental subluxation}}
A subluxation of a tooth is a [[dental trauma]]tic 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.<ref name="DentSL">{{cite journal |vauthors=Zadik Y, Levin L |title=Oral and facial trauma among paratroopers in the Israel Defense Forces |journal=Dent Traumatol |volume=25 |issue=1 |pages=100–102 |date=February 2009 |pmid=19208020 |doi=10.1111/j.1600-9657.2008.00719.x}}</ref> 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]],<ref name="AlDT">{{cite journal |author= Zadik Y |title=Algorithm of first-aid management of dental trauma for medics and corpsmen |journal=Dent Traumatol |volume=24 |issue=6 |pages=698–701 |date=December 2008 |pmid=19021668 |doi=10.1111/j.1600-9657.2008.00649.x}}</ref> 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.<ref name="AlDT"/> In [[toothache|painful]] situations, a temporary splinting of the injured tooth may relieve the [[pain]].<ref name="GuideDT">{{cite journal |last1=Flores |first1=Marie Therese |last2=Andersson |first2=Lars |last3=Andreasen |first3=Jens Ove |last4=Bakland |first4=Leif K. |last5=Malmgren |first5=Barbro |last6=Barnett |first6=Frederick |last7=Bourguignon |first7=Cecilia |last8=DiAngelis |first8=Anthony |last9=Hicks |first9=Lamar |last10=Sigurdsson |first10=Asgeir |last11=Trope |first11=Martin |last12=Tsukiboshi |first12=Mitsuhiro |last13=Von Arx |first13=Thomas |title=Guidelines for the management of traumatic dental injuries. I. Fractures and luxations of permanent teeth |journal=Dental Traumatology |date=April 2007 |volume=23 |issue=2 |pages=66–71 |doi=10.1111/j.1600-9657.2007.00592.x |pmid=17367451 }}</ref>

Subluxation may also occur in the [[Mandibular condyle|mandible]] from the articular groove of the temporal bone.<ref>{{cite web | url= http://emedicine.medscape.com/article/823775-overview | title= Mandible dislocation | first= Meher | last= Chaudhry | editor-first= Rick | editor-last= Kulkarni | work= Medscape Reference | publisher= WebMD LLC | date= April 19, 2012 | access-date= March 12, 2013 }}</ref> 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.<ref>{{cite encyclopedia | last1= Haddon | first1= Robert | last2= Peacock IV | first2= W Franklin | title= Face and Jaw Emergencies | encyclopedia= Emergency Medicine: A Comprehensive Study Guide | editor1-last= Tintinalli | editor1-first= Judith E | editor2-last= Kelen | editor2-first= Gabor D | editor3-last= Stapczynski | editor3-first= J Stephan | edition= 6th | publisher= McGraw-Hill | year= 2003 | section= 240 | pages= 1471–1476 | isbn= 978-0071388757 | name-list-style= amp }}</ref>

== Chiropractic ==

{{main|Vertebral subluxation}}

Unlike real subluxations, the [[pseudoscience|pseudoscientific]] concept of a [[chiropractic]] "[[vertebral subluxation]]" may or may not be visible on x-rays. Nor may it involve a significant displacement or even pain or clear dysfunction.<ref name="WHO_guidelines">{{cite book |title=WHO guidelines on basic training and safety in chiropractic |date=2005 |publisher=World Health Organization |isbn=978-92-4-159371-7 |hdl=10665/43352 |hdl-access=free |page= 4, including footnote }}</ref> [[Chiropractic#Straights and mixers|Straight chiropractors]] claim that vertebral subluxation has considerable health effects and also add a visceral component to the definition. Mainstream medicine and some [[Chiropractic#Straights and mixers|mixer chiropractors]] consider these ideas to be pseudoscientific and dispute these claims, as there is no scientific evidence for the existence of chiropractic subluxations or proof they or their treatment have any effects on health.<ref name=History-Primer2>{{cite web|title=Chiropractic history: a primer | author=Joseph C. Keating Jr. |author2=Cleveland CS III |author3=Menke M |url=http://www.historyofchiropractic.org/assets/documents/ChiroHistoryPrimer.pdf |year=2005 |access-date=2008-06-16 |publisher=Association for the History of Chiropractic |archive-date=19 June 2013 |archive-url=https://web.archive.org/web/20130619204140/http://www.historyofchiropractic.org/assets/documents/ChiroHistoryPrimer.pdf |quote=A significant and continuing barrier to scientific progress within chiropractic are the anti-scientific and pseudo-scientific ideas (Keating 1997b) which have sustained the profession throughout a century of intense struggle with political medicine. Chiropractors' tendency to assert the meaningfulness of various theories and methods as a counterpoint to allopathic charges of quackery has created a defensiveness which can make critical examination of chiropractic concepts difficult (Keating and Mootz 1989). One example of this conundrum is the continuing controversy about the presumptive target of DCs' adjustive interventions: subluxation (Gatterman 1995; Leach 1994). |url-status=dead }}</ref><ref name=Keating-subluxation>{{cite journal |journal= [[Chiropr Osteopat]] |year=2005 |volume=13 |pages=17 |title= Subluxation: dogma or science? |author1=Keating JC Jr |author2=Charlton KH |author3=Grod JP |author4=Perle SM |author5=Sikorski D |author6=Winterstein JF |doi=10.1186/1746-1340-13-17 |pmid=16092955 |pmc= 1208927 |issue=1 |doi-access=free }}</ref><ref>{{cite journal | author=Joseph C. Keating Jr. |journal=Skeptical Inquirer |volume=21 |issue=4 |pages=37–43 |title=Chiropractic: science and antiscience and pseudoscience side by side |year=1997 |oclc=203269785 }}</ref><ref>{{cite book|author= Phillips RB|chapter= The evolution of vitalism and materialism and its impact on philosophy|pages=65–76|title= Principles and Practice of Chiropractic|edition=3rd|veditors=Haldeman S, Dagenais S, Budgell B |publisher=[[McGraw-Hill]]|year=2005|isbn=978-0-07-137534-4|display-editors=etal}}</ref><ref name=Reggars2011>{{cite journal | author = Reggars JW | title = Chiropractic at the crossroads or are we just going around in circles? | journal = Chiropractic & Manual Therapies| volume = 19 | page = 11 | year = 2011 | pmid = 21599991 | pmc = 3119029 | doi = 10.1186/2045-709X-19-11 | doi-access = free }}</ref><ref>{{cite journal |vauthors=Suter E, Vanderheyden LC, Trojan LS, Verhoef MJ, Armitage GD | title = How important is research-based practice to chiropractors and massage therapists? | journal = Journal of Manipulative and Physiological Therapeutics| volume = 30 | issue = 2 | pages = 109–15 | date = February 2007 | pmid = 17320731 | doi = 10.1016/j.jmpt.2006.12.013 }}</ref>

== References ==
{{Reflist}}

[[Category:Medical terminology]]
[[Category:Dislocations, sprains and strains]]
[[Category:Joints]]
[[Category:Orthopedic surgical procedures]]
[[Category:Ophthalmology]]
[[Category:Acquired tooth disorders]]
[[Category:Bones of the vertebral column]]