Hill-Sachs lesion


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Related to Hill-Sachs lesion: reverse Hill Sachs lesion, Bankart lesion

Hill-Sachs defect

an irregularity seen in the head of the humerus following anterior dislocation of the shoulder; caused by impaction of posterolateral portion of the head of the humerus against the anterior edge of the glenoid.
Synonym(s): Hill-Sachs lesion

Hill-Sachs le·sion

(hil saks lē'zhŭn)
An articular cartilage defect on the posterior aspect of the humeral head, often caused by injury to the humeral head by the rim of the glenoid fossa after anterior glenohumeral dislocation.

Hill-Sachs lesion

(hil′saks′)
[Harold A. Hill, U.S. radiologist, b. 1901; Maurice Sachs, U.S. radiologist, b. 1909]
An osteochondral fracture of the posterolateral humeral head that occurs following an anterior dislocation of the glenohumeral joint. The lesion involves the cartilage of the humeral head, causing instability that may predispose the individual to subsequent anterior glenohumeral dislocations.

Etiology

A Hill-Sachs lesion occurs in about 40% of all first-time anterior dislocations and up to 80% of recurrent dislocations. The relative size of the lesion, as determined through an arthroscope or diagnostic imaging, can be used to ascertain the relative magnitude of the original dislocation.

Symptoms

Although many Hill-Sachs lesions are asymptomatic, pain may arise from the posterolateral humeral head when the glenohumeral joint is abducted to 90°, and passive external rotation is applied.

Treatment

Surgical repair may be needed to increase anterior stability of the glenohumeral joint.

Hill,

Harold A., U.S. radiologist, 1901–.
Hill-Sachs lesion - an irregularity seen in the head of the humerus following dislocation of the shoulder.

Sachs,

Maurice D., U.S. radiologist, 1909–.
Hill-Sachs lesion - see under Hill, Harold A
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References in periodicals archive ?
Patients were divided into four groups based on severity of pathology: a glenoid defect of less than 25% and an on-track Hill-Sachs lesion; a glenoid defect of less than 25% and an off-track Hill-Sachs lesion; a glenoid defect greater than 25% and an on-track Hill-Sachs lesion; and a glenoid defect greater than 25% and an off-track Hill-Sachs lesion.
Traumatic glenohumeral bone defects and their relationship to failure of arthroscopic Bankart repairs: significance of the inverted-pear glenoid and the humeral engaging Hill-Sachs lesion. Arthroscopy.
First-Time Traumatic Anterior Shoulder Instability: Management in the Young and Active Patient
Smalley, "Hill-Sachs "remplissage": an arthroscopic solution for the engaging Hill-Sachs lesion," Arthroscopy, vol.
Management of humeral and glenoid bone loss in recurrent glenohumeral instability
Arthroscopic Bankart repair is an established option for patients with isolated soft tissue Bankart lesions, yet Burkhart and coworkers reported a near 70% instability recurrence rate following soft tissue stabilization with underlying bony Bankart or Hill-Sachs lesions. (8) More extensive soft tissue injuries, including capsular attenuation, also have a high association with recurrent instability following Bankart repair.
Coracoid fracture following latarjet failure: a case report
(1.) Bock P, Kluger R, Hintermann B: Anatomical reconstruction for Reverse Hill-Sachs lesions after posterior locked shoulder dislocation fracture: a case series of six patients.
Reconstruction of a neglected locked posterior fracture--dislocation of humeral head: a case report
If a Hill-Sachs lesion remains within the glenoid track, then there is no chance of engagement (Fig.
Addressing the Hill-Sachs Lesion: humeral head bone loss and glenohumeral instability
(25) Using MR arthrography on re-evaluation of patients with a failed surgical stabilization has been shown to achieve of 93.3% in detection of Hill-Sachs lesions, 76.2% for glenoid or humeral cartilage abnormalities, and 87.2% for rotator cuff injury.
Current trends in the management of recurrent anterior shoulder instability
In addition, direct bone grafting for large Hill-Sachs lesions with allograft humeral head or femoral head has recently been advocated for "engaging Hill-Sachs lesions" as well.
Management of humeral and glenoid bone loss associated with glenohumeral instability: results with anatomical bone grafting
Specialized views include the Stryker notch view, (30) which aids in the evaluation of a Hill-Sachs lesion; the West Point Axillary view, (31) which is used to evaluate anteroinferior glenoid rim fractures; and the apical oblique view of Garth, (32) which is useful for the identification of anteroinferior glenoid fractures, labral calcifications, and for the evaluation of Hill-Sachs lesions.
Glenohumeral bone loss and anterior instability
In a recent biomechanical study, Sekiya and associates (27) evaluated the effect varying sizes of Hill-Sachs lesions had on the stability of the shoulder, and the impact treating these lesions with osteochondral allograft implantation had on restoring a stable glenohumeral joint.
The basic science and clinical applications of osteochondral allografts
Bencardino and colleagues (24) found that SLAP lesions were associated with partial rotator cuff tears in 42% of patients, frayed or lax inferior glenohumeral ligaments in 26%, Bankart lesions in 16%, Hill-Sachs lesions in 16%, chondral lesions in 16%, loose bodies in 10%, complete rotator cuff tears in 5%, and posterior labral tears in 5%.
The shoulder in baseball pitching: biomechanics and related injuries--Part 2
They reported a high variability in pathologic lesions associated with glenohumeral instability, including anterior glenoid labral tears (87%), anterior capsule deficiency (79%), Hill-Sachs lesions (68%), glenohumeral ligament disruptions (55%), rotator cuff tears (14%), posterior labral tears (12%), and SLAP (superior labrum, anterior to posterior) lesions (7%).
Arthroscopic stabilization of anterior shoulder instability: a historical perspective

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