A 28-year-old rugby player is brought to the emergency with an anterior shoulder dislocation. The Hill-Sachs lesion is best described as:
- A Impaction fracture of the anteroinferior glenoid rim
- B Impaction fracture of the posterolateral humeral head ✓
- C Avulsion of the anterior labrum from the glenoid
- D Tear of the inferior glenohumeral ligament
Correct answer: B. Impaction fracture of the posterolateral humeral head
Explanation
A Hill-Sachs lesion is a compression (impaction) fracture of the posterolateral aspect of the humeral head, occurring when the relatively soft cancellous bone of the humeral head impacts the hard anteroinferior glenoid rim at the time of anterior dislocation. A Bankart lesion refers to avulsion of the anteroinferior labrum (option C); a bony Bankart is a fracture of the anteroinferior glenoid rim (option A). The inferior glenohumeral ligament tear is a separate structure. Hill-Sachs lesions are seen in up to 80% of anterior dislocations.
Reference: Maheshwari Essential Orthopaedics, 6th ed.
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