Shoulder Dislocation | Diagnosis & Treatments

How does a doctor know my child has a shoulder dislocation?

A shoulder dislocation may resemble other conditions, such as a broken bone. If you suspect a shoulder dislocation, consult your child's doctor right away.

In addition to reviewing your child's full medical history, as well as asking about events that may have caused the shoulder dislocation, your child's doctor may test:

  • movement and appearance of your child's shoulder muscles
  • pulse at the wrist
  • touch sensation
  • hand movement
  • x-ray: a diagnostic test which uses invisible electromagnetic energy beams to produce images of internal tissues, bones, and organs onto film
  • magnetic resonance imaging (MRI): a diagnostic procedure that uses a combination of large magnets, radio frequencies, and a computer to produce detailed images of organs and structures within the body
  • radionuclide scans: nuclear scans of various organs to determine blood flow to the organs
  • electromyography (EMG): a test of the electrical signals in the muscles to determine the amount of muscle damage

How we treat shoulder dislocations

In most cases, your child's doctor can treat the shoulder dislocation without surgery.

  • gentle maneuvering to reset the bones in their original place, which may or may not require a general anesthetic
  • pain medication
  • a sling or splint to stabilize and immobilize the arm and shoulder

When is surgery needed?

Surgery is needed when the shoulder instability becomes a disability for your child. The need for surgery depends on the functional demands of your child and the degree of instability present. Typically, surgery is not done unless a conservative program of exercise has failed. Patients who have repeated shoulder dislocations may be good candidates for surgery.

  • Surgery attempts to restore an anatomic balance to the joint and address the problems that are causing the instability.
  • Repairs focus on tightening the stretched ligaments and/or repairing the labrum if it was torn at the time of injury.
  • In some situations, arthroscopic techniques, a minimally invasive outpatient procedure that inserts a small camera into the joint for the doctor to inspect, may be used, but in many situations, open repair is the favored technique.
  • The goal is to restore stability while maintaining mobility of the shoulder and providing pain-free range of motion.
  • Typical success rates for open surgery for shoulder instability vary from 90 to 95 percent.

How can we make sure the shoulder doesn't dislocate again?

Patients can often compensate for loose ligaments by increasing the strength and control of the rotator cuff and shoulder blade muscles. These muscle groups help pull the humeral head into the glenoid and will pull more tightly if they are strong.

  • Typical rehabilitation programs start with a short period of immobilization with a sling.
  • Progress to exercises like closed grip pull downs, rowing on a machine, and shrugs, for shoulder blade strength.
  • Strengthening programs for the rotator cuff include rotation exercises with the arm down at the side.
  • Resistant rubber tubing or cables may be used.
  • Exercises that increase coordination of the shoulder are also important and these include exercises with a medicine ball, and bouncing balls against the wall and the floor.