Presentation
Left shoulder deformity and pain after having his left arm suddenly pulled during a fight. Previous history of shoulder dislocations.
Patient Data
Anterior shoulder dislocation. On the frontal projection, the humeral head projects medial and inferiorly, overlapping the glenoid.
Post closed reduction
Control after closed reduction.
Adequate shoulder reduction in the frontal projection.
Posterolateral depression fracture in the humeral head (Hill-Sachs defect).
Small bony fragment in the anteroinferior aspect of the glenoid rim (bony Bankart lesion).
Case Discussion
The shoulder is the most commonly dislocated joint. Almost all of the dislocations are anterior.
In this case, proper lateral radiographs were unavailable. Thus, it is quite useful to know how to recognize an anterior dislocation on a frontal projection, in which the humeral head is displaced medial and inferiorly and the glenohumeral joint is incongruent.
In patients with a history of recurring anterior shoulder dislocations, the repeated impaction of the humeral head against the glenoid labrum can lead to lesions represented in this case:
Hill-Sachs defect: posterolateral depression fracture of the humeral head
Bankart lesion: anteroinferior injury to the glenoid labrum with or without impaction fracture of the glenoid rim
Unable to process the form. Check for errors and try again.