ABSTRACT
Shoulder dislocation in children must be approached from a completely different perspective than in adults. In children, dislocation of the shoulder may be paralytic, associated with ligamentous laxity syndromes, atraumatic or traumatic. Once the aetiology has been determined, then the shoulder dislocation should be classified according to three different criteria: subluxation or dislocation, severity of precipitating trauma and mode of dislocation. Acute dislocations must be reduced as soon as possible followed by a period of immobilisation. The rehabilitation programme must attempt to optimise the dynamic stabilisers of the shoulder. Surgical intervention should not be undertaken in children who dislocate the shoulder voluntarily. Most of these children can be managed by ‘skilful neglect’, that is no restriction of activities or physiotherapy. In children with paralytic dislocations there may be adaptive bony changes of the glenoid that include altered glenoid version and dysplasia.
