How are fractures and soft-tissue injuries diagnosed and treated in patients with shoulder dislocation?

Updated: Nov 29, 2018
  • Author: Sharon R Wilson, MD; Chief Editor: Trevor John Mills, MD, MPH  more...
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Answer

Hill-Sachs lesions occur when the edge of the glenoid causes an impaction fracture in the posterolateral aspect of the humeral head during anterior dislocation and in the anterolateral aspect in posterior dislocation (referred to as a "reverse Hill-Sachs" lesion).

A Bankart lesion is fracture of the anterior rim of the glenoid labrum associated with joint capsule rupture and inferior glenohumeral ligament injury. Significantly displaced anterior or posterior glenoid rim fractures require operative management. Most initial shoulder dislocations produce a Bankart lesion, particularly in younger patients.

Fracture of the greater tuberosity, acromion, coracoid, clavicle, and humeral neck also occur.

Rotator cuff traction injury is most common in elderly patients and in association with inferior dislocations. This is a commonly missed injury, with an average time of 7 months from injury to diagnosis of rotator cuff rupture in patients older than 40 years.

Patients who experience anterior shoulder dislocation are at increased risk for glenohumeral arthropathy. Average overall T1p values on MRI for humeral head cartilage in dislocated shoulders have been shown to be significantly greater than that in control patients. [25]


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