Orthopaedic Quiz 4

Question 1
The following is a shoulder x-ray of a 25yo female. In which direction has the shoulder been dislocated?

Frontal Case Source

Frontal
Case Source

Axial

Axial

Hover over the icon for the answer:
Anterior shoulder dislocation

Question 2
What are the common directions of shoulder dislocation?

Answer:
Anterior (subcoracoid) and/or antero-inferior (subglenoid)

Question 3
What are some predisposing factors to recurrent shoulder dislocations?

Answer:
Loose joint capsule, damage to the glenohumeral ligament, rotator cuff tear

Question 4
A modified axial view of the patient’s shoulder shows a bony defect on the greater tubercle in keeping with what type of lesion?

Modified axial Source

Modified axial
Source

Answer:
Hill-Sachs lesion: posterolateral humeral head compression fracture, typically secondary to recurrent anterior shoulder dislocations, as the humeral head comes to rest against the anteroinferior part of the glenoid

Question 5
The above lesion is commonly seen in association with what type of glenoid lesion?

Answer:
Bankart lesion: injury to the anteroinferior aspect of the glenoid labrum, often as a direct result of anterior dislocation of the shoulder