Children with a Dislocated Shoulder

A dislocated shoulder can happen as a result of a fall or a blow to the shoulder. Because of its mobility and ball-in-socket mechanism, the shoulder is the most likely joint in the body to dislocate.

Schedule an Appointment

If your child needs surgery or casting, our Fracture Care Clinic opens every day and you do not need an appointment. Surgery rooms get scheduled every morning, so your child receives the care and attention they need right away.

Dislocated Shoulder Defined

When the round ball at the top of the upper arm bone, or humerus, slips out of the socket in the shoulder blade, or scapula, this is referred to as a shoulder dislocation. That means the shoulder’s ball and socket bones are separated, and the ball of the humerus appears out of place. Muscles, tendons that connect muscles to bones, and ligaments that connect the shoulder bone to the shoulder blade are all injured tissues that hold the bones together. Furthermore, cartilage tearing is possible. Cartilage is a rubbery tissue that covers and protects the ends of bones. A partially dislocated shoulder, also known as a shoulder subluxation, occurs when only a portion of the upper arm bone is out of place.

Why Does the Shoulder Dislocate?

The most mobile joint in the body is the shoulder joint, which is a ball-in-socket mechanism with the round top of the arm bone fitting into a groove in the shoulder blade. It has the ability to turn in a variety of directions. Even though the shoulder gets supported by muscles, tendons, and ligaments, its mobility can make it unstable. The shoulder is the most prone to dislocation of any joint in the body.

What Causes a Dislocated Shoulder?

A fall or blow to the shoulder can cause a shoulder dislocation. This can occur during sporting events. Shoulder dislocations appear more common in teenagers than in younger children.

The Signs of a Dislocated Shoulder

Severe pain and/or weakness
Bruising or skin discoloration.
Muscular spasms
Arm, hand, or finger numbness, tingling, or weakness
Arm immobility or difficulty moving it.
Visibly displaced shoulder.

If you believe your child’s shoulder is dislocated, follow these steps:

Keep the arm close to the body. Try not to force the shoulder back into place, as this can cause additional discomfort and potentially worsen the injury.
Wrap an ice pack around the injured area. Because Ice can help with swelling and pain relief.
To relieve pain, take ibuprofen (Advil® or Motrin®), naproxen (Aleve® or Naprosyn®), or acetaminophen (Tylenol®). It’s always best to consult with a doctor before giving your children any pain medication.

QUESTIONS AND ANSWERS

What defines a dislocated shoulder in children, and how does it occur?

A dislocated shoulder in children occurs when the upper arm bone (humerus) pops out of the shoulder socket (glenoid). This displacement results in a partial (subluxation) or complete dislocation. Dislocations usually result from a significant force or trauma, such as a fall on an outstretched arm, a collision during sports, or a direct blow to the shoulder.

What symptoms and signs indicate a dislocated shoulder in children?

Children with a dislocated shoulder often experience severe pain, swelling, and an obvious deformity or bump at the shoulder. They may hold the arm in an abnormal position, have difficulty moving the shoulder, and may not use the affected arm due to pain. In some cases, numbness or tingling may exist down the arm if nerves around the shoulder become affected.

How do doctors diagnose and treat a dislocated shoulder in children?

Diagnosis involves a thorough physical examination and often imaging studies such as X-rays or an MRI to confirm the dislocation, assess the severity, and check for associated injuries. Treatment typically involves reducing (relocating) the dislocated shoulder back into its socket, usually performed by a healthcare professional. After reduction, the child may wear a sling or shoulder immobilizer to support and protect the shoulder. Physical therapy is essential for rehabilitation to restore strength, range of motion, and stability to the shoulder joint.

When it comes to children and their medical conditions, parents need to think of the very best — Medical City Children’s Orthopedics and Spine Specialists.

Diagnosing a Dislocated Shoulder?

Tell the doctor how the suspected dislocation occurred and whether the shoulder has been dislocated before. To alleviate pain, the doctor may prescribe muscle relaxants. X-rays, an MRI scan to detect tissue damage, or a computerized tomography (CT) scan to reveal any broken bones not visible on the X-ray are among the tests the doctor may order. Our doctors can identify a dislocation by simply feeling the top of the arm bone.

Treating a Dislocated Shoulder

The procedure to put the shoulder bone back into place is the most common one for doctors to treat. Your doctor may try some gentle maneuvers to get your child’s shoulder bones back into place. Depending on the severity of pain and swelling, your child may need a muscle relaxant, sedative, or, in rare cases, a general anesthetic before having the shoulder bones manipulated. Severe pain should disappear almost immediately after the shoulder bones get placed back where they belong.

Surgery. If your child has a weak shoulder joint or ligament and has recurring shoulder dislocations despite proper strengthening and rehabilitation, your child may need surgery. In very rare cases, your child’s nerves or blood vessels can become damaged, and in these cases, surgery is required.

Immobilization. For a short period of time, our doctor may provide a special splint or sling to keep your child’s shoulder from moving. The length of time your child wears the splint or sling depends on the nature of the shoulder dislocation.

Medication. To keep your child comfortable while his or her shoulder heals, your doctor may prescribe a pain reliever or a muscle relaxant.

Rehabilitation. Following the removal of a shoulder splint or sling, your child will begin a gradual rehabilitation program to restore range of motion, strength, and stability to the shoulder joint.

If your child has a fairly simple shoulder dislocation with no major nerve or tissue damage, the shoulder joint will likely improve over a few weeks, but children who have one dislocation may get future ones. Resuming activity too soon after a shoulder dislocation may cause your child to injure or dislocate the shoulder joint again. Before resuming activities that would stress the shoulder, such as sports, parents should consult one of our doctors.

Repairing Tissue Tears in the Shoulder

When a child dislocates their shoulder, they may tear ligaments, tendons, and other tissues. If these tissues are damaged, our doctors will in some cases consider surgery to repair them. For some people, this can significantly reduce their chances of dislocating the same shoulder again in the future. The repair of shoulder tissues is performed by surgeons under general anesthesia. It frequently gets performed using arthroscopic surgery, which involves making small cuts (incisions) and inserting a thin tube with a light and camera at one end (arthroscope). Surgeons perform open surgery to move bones in the shoulder to prevent further dislocations. If the tissues are overstretched but not torn, certain exercises can strengthen the shoulder and avoid surgery.

Pain Alleviation

Upon our doctors placing the shoulder back in place, your child may experience some pain for the first few days at home. To stop the pain, our doctors will prescribe over-the-counter pain relievers like anti-inflammatories. Always adhere to the dosage instructions on the package. If this does not relieve the pain, your doctor may prescribe a stronger pain reliever. Once the sling is removed and your child begins to move his or her shoulder, the pain should subside fairly quickly.

Rest Period

Although you can remove the sling from your child after a few days, it takes 12 to 16 weeks to fully recover from a dislocated shoulder. Most activities can start within two weeks, but heavy lifting and sports involving shoulder movements should not take place for three months. If your child has also broken his or her arm or shoulder, your child may need to wear his or her sling for up to 6 weeks as recovery will take longer.

Having Surgery for a Dislocated Shoulder

Surgery does not usually take place, especially if the dislocation never happened before. However, if bones or tendons are injured, the doctor may recommend surgery. If the shoulder is dislocated more than once, which is more common in young athletes, doctors may repair or tighten ligaments that connect the arm bone to the shoulder blade surgically.

When Should I Consult a Doctor After Receiving Treatment for a Dislocated Shoulder?

If swelling or pain occurs in the shoulder, arm, or hand that gets worse over time, or if the arm or hand turns purple, the patient should contact his or her doctor. A fever is another red flag. If the injury does not heal as expected, a doctor may order a scan to look for new tissue tears.

Avoiding a Shoulder Dislocation

Athletes can wear protective equipment while participating in sports to avoid dislocating their shoulders. Parents should avoid tugging and pulling on their children’s arms.

Follow These Steps to Help Relieve Pain and Promote Healing for a Dislocated Shoulder:

Relax the shoulder. Avoid painful movements and avoid repeating the specific action that caused the shoulder to dislocate. Heavy lifting or overhead activity should not take place until your child’s shoulder feels better.
Apply ice first, then heat. Applying ice to a shoulder reduces inflammation and pain. For 15 to 20 minutes at a time, apply a cold pack, a bag of frozen vegetables, or an ice cube-filled towel. Do this every few hours for the first day or two. When the pain and inflammation have subsided after two or three days, hot packs or a heating pad may help relax tight and sore muscles. Heat applications should not exceed 20 minutes at a time.
Per the doctor’s instructions, utilize pain relievers. OTC pain relievers include aspirin, ibuprofen (Advil, Motrin IB, and others), naproxen sodium (Aleve), and acetaminophen (Tylenol, among others). Follow the doctor’s directions and discontinue the medications once the pain has subsided. Maintain a shoulder’s range of motion. Have your child conduct some gentle exercises as directed by your doctor or physical therapist after one or two days to help maintain the shoulder’s range of motion. Joint stiffness can result from inactivity.

Have your child continue exercising once the injury becomes healed and your child regains a good range of motion in the shoulder. Daily shoulder stretches, as well as a shoulder-strengthening and stability program, can help prevent dislocations from recurring. A physical therapist or your doctor can assist you in developing an appropriate exercise routine for your child.

The Prognosis for a Dislocated Shoulder

A dislocated shoulder will feel unstable or dislocated again. Furthermore, with each subsequent injury, the shoulder becomes easier to dislocate. In older patients who have had shoulder dislocations, the rotator cuff – a group of muscles and tendons surrounding the shoulder joint – is more likely to tear. If the condition becomes chronic, a brace can help. A pediatric orthopedist should monitor children to ensure that proper healing is progressing. We are experts with children and dislocated shoulders and we invite parents to call us and make appointments for their children.

Why Choose Medical City Children’s Orthopedics and Spine Specialists

The very first reason to choose Medical City Children’s Orthopedics and Spine Specialists for your child is because we are experts in children’s health. In as much as there is a big difference between a dislocated shoulder and other shoulder problems, parents should want their child treated for the exact cause and we can deliver that treatment. We do it all the time in our Arlington, Dallas, Flower Mound, Frisco, and McKinney, TX offices. To obtain the very best diagnosis and treatment, we invite parents to give us a call to make an appointment for their child for any pain coming from their child’s shoulder.

____________________

Footnote:

American Academy of Orthopaedic Surgeons: Dislocated Shoulder

Call 214-556-0590 to make an appointment.

Comprehensive services for children from birth through adolescence at five convenient locations: Arlington, Dallas, Flower Mound, Frisco and McKinney.