Children's Hospital Colorado

Dislocated Shoulder in Children

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What is a dislocated shoulder?

A dislocated shoulder, also known as shoulder instability, is a condition in which the humeral head (ball) comes out of the glenoid (socket). The shoulder is the most frequently dislocated joint in the body. It usually occurs during contact sports such as football, basketball, wrestling and hockey. It can also dislocate from a fall in sports like skiing.

Most commonly, the ball dislocates to the front of the socket (anterior dislocation of the shoulder). Fewer than 5% of all dislocations occur in other directions.

Who is at risk for a dislocated shoulder?

The most commonly affected are male, adolescent athletes involved in contact sports. Shoulder dislocation is difficult to prevent, but proper technique and training can help.

Adolescents suffering a first-time shoulder dislocation are at high risk for dislocating again, even with proper initial treatment. The reason for this is that when the shoulder dislocates, it can tear some of the ligaments and cartilage that function to stabilize the joint. This is called a Bankart lesion.

Some athletes are at very high risk for a second dislocation. In these individuals and in patients who have dislocated a second time, surgical repair of the Bankart lesion provides the best chance at stopping future dislocations.

What are signs and symptoms of a dislocated shoulder?

When a shoulder dislocation occurs, there is immediate pain and loss of use of the arm. Many people report that their arm feels numb. There is usually a visible deformity of the shoulder and there may be a prominence in the front of the shoulder.

Patients with a dislocated shoulder (also known as shoulder instability) generally hold their arm at the side, and it is very uncomfortable to move the arm away from the body.

How is a dislocated shoulder diagnosed?

Most times, doctors at Children's Hospital Colorado can diagnose a dislocated shoulder just by looking at the shoulder. If there is any doubt, X-rays provide the definitive diagnosis.

How is a dislocated shoulder treated at Children's Colorado?

The initial treatment for a shoulder dislocation is "reduction," which means putting the ball back into the socket. Many times, medical professionals can do this right after the dislocation happens, even on the field. Other times, the dislocation is more difficult and the patient must go to the emergency room for medications to relax the muscles before the shoulder can be put back into place.

After the shoulder is put back in place, it is generally immobilized (held still) in a sling for a short period of time, followed by physical therapy.

In some cases, ligament repair in the shoulder is needed, which is usually done arthroscopically (through several small incisions, using a camera to see inside the joint). This technique allows for decreased pain and faster return of shoulder motion.

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