Bony bankart and Hill-Sach defect

Case contributed by Mohamed Mahmoud Elthokapy

Presentation

History of recurrent left anterior shoulder dislocations.

Patient Data

Age: 30 years
Gender: Male

Evidence of anterior inferior glenoid rim complete fracture denoting bony bankart lesion.

Flattening and cortical irregularity at the superolateral aspect of the humeral head denoting Hill Sach fracture.

Fracture of the anterior glenoid bony rim involving the attachment of the anterior labrum and the articular cartilage with surrounding bone marrow edema (bony bankart lesion).

Patchy bone marrow contusion is seen involving the posterolateral aspect of the humeral head (Hill Sachs fracture).

Minimal glenohumeral joint effusion

Mild bursal fluid collection in the subscapularis recess.

Case Discussion

Bony Bankart lesions occur when some of the glenoid bone is broken off with the anterior labrum. This leads to loss of the normal bumper (labrum) and also loss of bone, making the shoulder joint potentially more unstable than a Bankart tear alone. 

Note associated minor Hill-Sachs impaction defect to the posterosuperior aspect of the humeral head is frequently associated.

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