When the damage only involves the labrum it is called a Bankart lesion. A Hill- Sachs lesion occurs when the lesion to the labrum presents simultaneously with a. There are two types of labral tears: SLAP tears and Bankart lesions. On MR a Hill-Sachs defect is seen at or above the level of the coracoid. Horst and his colleagues also found that a larger Hill-Sachs lesion leads to greater . Burkhart and de Beer first described the concept of engaging vs. . Bankart repair and remplissage for a large engaging Hill-Sachs lesion.
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Assessment of the glenoid defect There are various methods of assessing the bony defect of the glenoid, such as radiography, 15 – 17 CT, 18 3D CT, 19 MRI 20 and arthroscopy. There are two types of labral tears: Osseous defects in the glenohumeral joint banakrt issues that can cause severe shoulder instability with high risk of recurrent dislocations.
Dislocations, sprains and strains Orthopedic problems Lesion. Another patient with an avulsion of the inferior glenohumeral ligament from the humeral insertion. It had been said that a bony defect of one-third of the glenoid or greater needs to be treated.
Mechanics of glenohumeral instability. Current concepts in the management of recurrent anterior gleno-humeral joint instability with bone loss.
J Orthop Lesioj ; 9: Ramhamadany E, Modi CS. Clinical validation of the glenoid track concept in anterior glenohumeral instability. We still do not know how much size discrepancy between a glenoid defect and a fragment would be acceptable.
Shibayama and Iwaso found that an engaging Hill-Sachs lesion is highly susceptible to recurrence if treated with a typical arthroscopic capsuloligamentous repair with no attention to the osseous defect [ 6 ]. Sometimes an axillary view can be of help, but when in doubt go to CT. On the other hand, 16 out of the 19 dr Loading Stack – 0 images remaining. Now, it has been shown in the literature that both open and arthroscopic surgeries are viable options with similar outcomes and failure rates [ 34 ].
Retrieved 11 May CT scan showing a bony Bankart lesion at the antero-inferior glenoid. The position of the arm at the initial dislocation event and angle of the Hill-Sachs lesion is another predictor engagement and instability.
Hill-Sachs lesion | Radiology Reference Article |
The bakart recent literature covering the Hill-Sachs lesion has focused on the relatively new and unexplored topic of the importance of concomitant injuries while treating a humeral head defect. The average depth dd Hill—Sachs lesion has been reported as 4. The higher angle caused from the arm being in abduction resulted in a more slanted lesion with sacus to the longitudinal axis of the humerus, which led to a higher degree of engagement and subsequent shoulder instability Fig.
It is the articulation between the glenoid of the scapula and the head of the humerus. Dynamic examination after the Bankart repair: Arthroscopic repair of glenoid fractures using suture anchors. A rigid body model for the assessment of glenohumeral joint mechanics: For off-track lesions, either remplissage or Latarjet procedure is indicated, depending upon the glenoid defect size and the risk of recurrence.
The role of atmospheric pressure in stabilising the shoulder. It is the most dislocated joint in the body. Hill—Sachs lesion Anterior shoulder dislocation on X-ray with a large Hill—Sachs lesion Classification and external resources [ edit on Wikidata ]. Weber osteotomy for large Hill-Sachs defects: Clinical examination provides a good indication for a dislocated shoulder and possibly other associated pathologies.
They used a kyphoplasty balloon to reduce the Hill-Sachs lesion and then injected bone cement into the void.
‘On-track’ and ‘off-track’ shoulder lesions
How to identify and calculate glenoid bone deficit. This article has been cited by other articles in PMC. Musculoskeletal imaging, the requisites. For patients that are poor surgical candidates i. There are benefits and drawbacks to each technique, and they must all be considered based on the size of the humeral head lesion and for each unique patient situation.
With the assistance of intraoperative and preoperative measurements, an implant of appropriate size is chosen to repair the anatomic defect and secured into place. To quiz yourself on this article, log in to see bankary choice questions. Post-surgical rehabilitation should be guided by the orthopaedic surgeon, and depends on the procedure that was done.
Contact bankartt the glenoid and the humeral head in abduction, external rotation, and horizontal extension: As mentioned previously, HSL is related to the end-range instability. Injuries of shoulder and upper arm Musculoskeletal disorders Orthopedic problems Lesion. They were able to show a The results showed that 3D-CT osseous reconstructions were equivalent to 3D-MR osseous reconstructions, and the measurement differences were found to be statistically insignificant.