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Humeral Bone Deficiency

Humeral head defects are commonly present in patients with shoulder instability. The defects are usually small and carry the eponym Hill-Sachs lesion when secondary to anterior instability and reverse Hill-Sachs lesions when secondary to posterior instability.

Although quite ubiquitous in recurrent anterior shoulder instability, the management of large Hill-Sachs defects remains controversial especially in […]

Imaging

The minimum radiographic workup necessary for evaluation of an acute dislocation or suspected subluxation is a true anteroposterior (AP) view and an axillary lateral view. These images will allow accurate determination of the position of the humeral head relative to the glenoid.

A true AP radiograph is obtained by angling the x-ray beam 45 […]

Hill-Sachs Lesions

The most common bony lesion associated with traumatic glenohumeral instability is a compression fracture at the posterolateral margin of the humeral head Commonly known as a Hill-Sachs lesion, this fracture occurs as the humeral head impacts the glenoid edge during dislocation.

The lesion is present in 80% of anterior dislocations, 25% of anterior subluxations, […]

Anterior Shoulder Dislocation

SYMPTOMS

There is acute onset of localised swelling and pain over the anterior part of the shoulder with deformation, after an excessive external rotation and abduction trauma. This is the most common type of dislocation in sports (85-90 per cent). Movements of the arm cause pain and the patient will protect the arm in […]

Shoulder Instability

Basics Description Because of the shoulder’s extensive ROM, it is prone to instability. The term encompasses a spectrum of disorders of varying degree, direction, and cause. Instability should be distinguished from laxity. Laxity is the symmetric translation of the humeral head over the surface of the glenoid without symptoms. Instability occurs when the degree […]

Shoulder Dislocation

Basics Description The shoulder joint has the greatest ROM of all joints in the body and, thus, is at high risk for dislocations. Shoulder joint stability depends on various dynamic and static anatomical restraints. Dynamic restraints include: Tendon of the long head of the biceps Scapular stabilizers Rotator cuff muscles and tendons Static restraints […]