There’s nothing a child loves more than his playtime and play is a particularly important part of your child’s overall growth and development. But while engaging in playground play or contact sports there is also a risk of injuries. Dislocations happen to be a commonly seen injury and incidentally the most commonly dislocated joint is the shoulder.

A dislocation occurs when extreme force is put on a joint, like when the child falls or takes a hit to the body while playing a contact sport. When this happens the ligaments that are fibrous tissue that joins various bones and cartilage could be torn. A child’s shoulder can get dislocated when the knobby head of the upper arm bone slips out of its socket and stretches or tears the supporting ligaments and surrounding muscles.

Your child’s shoulder may be partially or completely dislocated if he has fallen on it or received a blow to the area. A shoulder dislocation though is not common in younger children as their growth plates which are the areas at the end of long bones where the bones grow is weaker than the muscles or tendons. Shoulder dislocations happen more often among teens.

Every child may experience different symptoms but the most common among them are pain, swelling, bruising or redness, numbness or weakness, deformity or trouble using or moving the joint in a normal way. The important thing to remember is to get a formal diagnosis from a specialist without delay and that the parents should never try to reposition the bone. This will only put the child in more excruciating pain when there is additional damage to the surrounding tissues.

A shoulder dislocation diagnosis can be done with a physical exam or with the help of imaging techniques like X-ray or MRI. In the case that the injury is more severe and the bone cannot be repositioned or if the damage involves nerves or blood vessels, a surgery may be necessary. An MRI will be requested only if surgical intervention is needed.

To set the shoulder dislocation right the child may be sedated before the doctor can reposition the bone and immobilize the arm with a sling, splint, or cast, depending on the extent of the injury. While taking the child to the doctor try to support the arm and shoulder in whatever position they’re in by making a sling out of a piece of cloth. Ice can be applied to reduce the swelling and make sure the child isn’t given any food or drink in case a surgery needs to be performed.

After the procedure the child will be required to rest and special exercises may be recommended to help strengthen the surrounding muscles. The affected shoulder must be placed in a sling for at least two to three weeks for adequate healing. Once the sling is removed there shouldn’t be any pain but some stiffness should be expected. Encourage the child to use the arm slowly and all sports or rough activities should be avoided till the doctor gives a go ahead.

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Q&As on Shoulder Dislocation in Children

1.How to do icing post shoulder debridement surgery?

For the first 7 to 14 days following surgery, icing is crucial. A cooling device rental or purchase will be available to you; this will be arranged before surgery. A bag of ice or the cooling device should be used as often as possible during the first 3–4 days. After four days, ice or a cooling device is used at least four times daily for 20-minute intervals. A layer of clothes, a fabric, or a towel should be placed between the ice and the skin to prevent frostbite.

2.How to prepare for shoulder debridement surgery?

  • You generally won’t be allowed to have or sip anything after midnight on the evening before your procedure. By doing this, you’ll have a lower chance of throwing up when unconscious.
  • Make arrangements for someone to assist you in leaving the hospital and drive you home after you are discharged since the anaesthesia and painkillers may make you sleepy, and you won’t be able to go.
  • Wear a soft, comfy shirt underneath a shoulder sling so it won’t bother your skin.
  • Make sure you’ve gotten any equipment you’ll need after you leave the hospital and go home—for instance, a heating pad or an ice pack as prescribed by the doctor. 

3.How is the recovery after shoulder debridement surgery?

Some discomfort, tightness, and stiffness are common after extensive debridement shoulder surgery. You need to look for specific symptoms and indicators that might portend difficulties. On the second day after surgery, a fever

  • Increasing discomfort or swelling
  • A wound infection may be indicated by redness, warmth, or pain.
  • Unusual bleeding (some surgical wound drainage is common and even desired
  • Arm or hand tingling or numbness
  • Move the hands and fingers in the sling to promote blood flow as much as possible.

4.How to prevent shoulder debridement?

Using the strengthening exercises you learned throughout therapy is the safest approach to stop rotator cuff injuries from happening again. You should always warm up and extend your shoulders before working out. To avoid damage, all rotator cuff muscles must be flexibly toned via an exercise routine. Your work environment may also need to change to prevent repetitive overhead tasks. In general, doctors advise icing your shoulder after exercise. Competitive athletes who engage in sports that create swelling in their shoulders may need anti-inflammatory drugs like aspirin and ibuprofen after the activity. 

5.How to care for incision post shoulder debridement surgery?

You will have thick bandages for 48 hours after surgery before they may be removed. Put on another thick bandage if you feel any fluid escaping. You may see blue or purple sutures under the wrap; do not remove them. Sutures will be taken at your first post-operative appointment (typically 10-14 days after surgery). You will see steri-strips beneath your armpit if you had a biceps tenodesis performed simultaneously with your decompression. At your first post-operative appointment, these steri-strips will be removed. Thus they should be kept in place. Forty-eight hours following surgery, you may take a shower. Lean forward and hang your arm before you wash the underarm region.

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