From the Guidelines
A child with a shoulder dislocation can still move their arm to some extent, but the movement is significantly limited and painful, especially in the shoulder joint itself. The limitation in movement is primarily due to the severe pain and mechanical obstruction caused by the dislocation, where the head of the humerus is forced out of the shoulder socket, disrupting normal joint mechanics and stretching or tearing surrounding tissues 1.
Key Points to Consider
- The ability to move the arm is significantly limited, especially with movements that involve raising the arm or rotating the shoulder.
- Most children will hold the affected arm close to their body in a protective position and resist any movement.
- Some partial movement might still be possible, particularly at the elbow, wrist, and fingers.
- If a shoulder dislocation is suspected in a child, immediate medical attention is necessary to avoid further complications.
Importance of Medical Attention
It is crucial not to attempt to relocate the shoulder at home, as this could cause further damage 1. While waiting for medical care, the arm should be immobilized in a comfortable position, possibly with a makeshift sling. Pain management with age-appropriate doses of acetaminophen or ibuprofen may help with discomfort until professional treatment can be provided. Radiographic evaluation, including anteroposterior views in internal and external rotation and an axillary or scapula-Y view, is vital for assessing the extent of the injury and guiding appropriate management 1.
From the Research
Ability to Move the Arm with a Shoulder Dislocation
- A child with a shoulder dislocation may still be able to move their arm to some extent, but the movement will likely be limited and painful 2.
- The range of motion and ability to move the arm will depend on the severity of the dislocation and the individual child's condition 3.
- In some cases, children may be able to participate in an accelerated rehabilitation program to expedite their return to play, but this will depend on various factors, including the presence of structural abnormalities and the child's activity goals 4.
Factors Affecting Arm Movement
- The type and severity of the dislocation, as well as the presence of any associated injuries, such as bony Bankart lesions or Hill-Sachs humeral head depression fractures, can impact the child's ability to move their arm 4, 5.
- The child's age and activity level can also influence the treatment approach and the likelihood of recurrent instability 5, 6.
- Immobilization strategies, such as the use of a sling or brace, can help to reduce pain and promote healing, but may also limit arm movement 5.
Treatment Approaches
- Surgical stabilization is becoming more frequently performed in adolescents with shoulder dislocations, particularly in cases where there are structural abnormalities or a high risk of recurrent instability 4, 6.
- Nonoperative management, including immobilization and rehabilitation, may be recommended for younger children or those with less severe dislocations 2, 5.
- The choice of treatment approach will depend on various factors, including the child's age, activity level, and the severity of the dislocation, as well as the presence of any associated injuries 4, 6.