Dislocations in Children

What are dislocations in children?

A dislocation is a joint injury. It occurs when the ends of 2 connected bones come apart. It's not common in younger children. This is because their growth plates are weaker than the muscles or tendons. Growth plates are the areas at the end of long bones where the bones grow. Dislocations happen more often among teens.

What causes a dislocation in a child?

A dislocation happens when extreme force is put on a joint. It can occur if your child falls or takes a hit to the body, such as while playing a contact sport.

When a dislocation occurs, ligaments can be torn. Ligaments are flexible bands of fibrous tissue. They join various bones and cartilage. They also bind the bones in a joint together. The hip and shoulder joints, for example, are called ball and socket joints. Lots of force on the ligaments in these joints can cause the head of the bone (ball) to partly or fully come out of the socket. The most commonly dislocated joint is the shoulder.

What are the symptoms of a dislocation in a child?

Each child may feel symptoms a bit differently. But below are the most common symptoms a child will have in the dislocated area:

• Pain
• Swelling
• Bruising or redness
• Numbness or weakness
• Deformity
• Trouble using or moving the joint in a normal way

These symptoms may seem like other health problems. Have your child see their healthcare provider for a diagnosis.

How is a dislocation diagnosed in a child?

Your child’s healthcare provider makes the diagnosis with an exam. During the exam, they will ask about your child’s health history and how the injury happened.

Your child may also need:

• X-rays. This test makes images of internal tissues, bones, and organs.
• MRI. This test uses a combination of large magnets, radio waves, and a computer to make detailed images of organs and structures within the body. An MRI is often done only if surgery may be needed.

How is a dislocation treated in a child?

Treatment will depend on your child’s symptoms, age, and general health. It will also depend on how severe the condition is.

All dislocations need medical care right away to prevent additional injury. Untreated dislocations can lead to serious problems. Treatment may include:

• R.I.C.E. This stands for rest, ice, compression, and elevation of the dislocated area.
• Repositioning. Sometimes the bone ends may go back into place by themselves. If not, your child’s healthcare provider will need to manually move the bones back into their correct position so the joint can heal. You may be referred to an orthopedic specialist before or after repositioning.
• Splint or cast. This treatment keeps the dislocated area in place while it heals. It also protects the area from motion or use.
• Medicine. Certain medicines can ease pain.
• Traction. This treatment gently stretches the muscles and tendons around the bone ends to help with the dislocation. It uses pulleys, strings, weights, and a metal frame attached over or on the bed.
• Surgery. Your child may need this treatment if the dislocation happens again and again. It may also be done if a muscle, tendon, or ligament is badly torn or if the dislocation can't be repositioned without surgery.

Your child’s healthcare provider may also advise:

• Limits on activity while the dislocation heals
• Crutches or a wheelchair so your child can move around during healing
• Physical therapy to stretch and strengthen the injured muscles, ligaments, and tendons

Key points about dislocations in children

• A dislocation happens when extreme force is put on a joint, causing the ends of 2 bones to come apart.
• A dislocation can cause pain, swelling, and weakness. Your child may also have trouble moving the injured area.
• An exam and X-rays are often needed to diagnose a dislocation.
• The bones must be put back into their correct position so the joint can heal. Other treatments include casts, splints, pain relievers, and surgery.

Next steps

Tips to help you get the most from a visit to your child’s healthcare provider:

• Know the reason for the visit and what you want to happen.
• Before your visit, write down questions you want answered.
• At the visit, write down the name of a new diagnosis, and any new medicines, treatments, or tests. Also write down any new instructions your provider gives you for your child.
• Know why a new medicine or treatment is prescribed and how it will help your child. Also know what the side effects are.
• Ask if your child’s condition can be treated in other ways.
• Know why a test or procedure is recommended and what the results could mean.
• Know what to expect if your child does not take the medicine or have the test or procedure.
• If your child has a follow-up appointment, write down the date, time, and purpose for that visit.
• Know how you can contact your child’s healthcare provider after office hours. This is important if your child becomes ill and you have questions or need advice.