Shoulder Dislocation

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KEY POINTS

• A shoulder dislocation means that the head of the upper arm bone moves out of the shoulder socket so that the shoulder joint no longer works properly.
• Your child needs to change or stop doing the activities that cause pain until the injury heals.
• Treatment may include putting the bones back in the right position, a sling or shoulder immobilizer, physical therapy, or sometimes surgery.

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What is a shoulder dislocation?

A shoulder dislocation means that the head of the upper arm bone moves out of the shoulder socket so that the shoulder joint no longer works properly. The dislocation can put pressure on the nerves and blood vessels in your child’s shoulder and arm and damage them.

The healing process may take 4 to 6 weeks, depending on the injury. With proper healing, your child should regain full movement of the shoulder.

What is the cause?

A fall onto the hand or shoulder can twist the upper arm or force your child’s arm into an awkward position and dislocate the shoulder. It may also be caused by weak or loose ligaments that your child was born with. Ligaments are strong bands of tissue that connect one bone to another. Other members of your family may have the same problem.

Elbow dislocation can happen when your child’s arm gets pulled and the ligaments are loose. Ask your child’s healthcare provider about this condition.

What are the symptoms?

Symptoms may include:

• Swelling
• Pain in your child’s shoulder and upper arm that gets worse with movement
• Bruising
• A large bump under the skin in front or back of your child’s shoulder
• A change in the shape of the shoulder that makes it look square instead of round
• Trouble moving the shoulder or not being able to move it at all
• Weakness or numbness in your child’s shoulder or arm

How is it diagnosed?

Your child’s healthcare provider will ask about your child’s symptoms and medical history and examine your child. Your child will have X-rays.

How is it treated?

A dislocated shoulder needs treatment right away to prevent permanent damage to the nerves and blood vessels.

Your child’s healthcare provider will put the bones back in the right position. Before the procedure, your child will be given medicine to help him or her relax but may be awake during the procedure. Your child may be given medicine to keep him or her from feeling pain when this is done. The healthcare provider will place your child’s shoulder and arm in a type of sling called a shoulder immobilizer. It keeps the arm next to the body and stops your child from moving the injured shoulder. Your child will wear the immobilizer for 4 to 6 weeks. Your child may start rehabilitation exercises during this time or after he or she is no longer wearing the immobilizer.

In some cases, surgery may be needed. If your child’s shoulder joint dislocates often, your child may need surgery to tighten the ligaments that hold the joint together.

How can I take care of my child?

Follow the full course of treatment prescribed by your child’s provider. In addition:

• Put an ice pack, gel pack, or package of frozen vegetables wrapped in a cloth on the injured area every 3 to 4 hours for up to 20 minutes at a time.
• Give your child nonprescription pain medicine, such as acetaminophen, ibuprofen, or naproxen. Read the label carefully and give your child the correct dose as directed.
  • Nonsteroidal anti-inflammatory medicines (NSAIDs), such as ibuprofen, naproxen, and aspirin, may cause stomach bleeding and other problems.
  • Check with your healthcare provider before you give any medicine that contains aspirin or salicylates to a child or teen. This includes medicines like baby aspirin, some cold medicines, and Pepto-Bismol. Children and teens who take aspirin are at risk for a serious illness called Reye’s syndrome.
  • Acetaminophen may cause liver damage or other problems. Do not give more doses than directed. To make sure you don’t give your child too much, check other medicines your child takes to see if they also contain acetaminophen. Unless recommended by your healthcare provider, your child should not take this medicine for more than 5 days.
• Your child will need to change or stop doing the activities that cause pain until the injury has healed.
• Make sure that your child does the exercises recommended by your child’s healthcare provider.

Ask your healthcare provider:

• How long it will take to recover
• What activities your child should avoid and when he or she can return to normal activities
• How to take care of your child at home
• What symptoms or problems you should watch for and what to do if your child has them

Make sure you know when your child should come back for a checkup. Keep all appointments for provider visits or tests.