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Anterior Dislocation of the Shoulder

 

·         Glenohumeral dislocation most common shoulder dislocation (85%)

·         Glenohumeral joint dislocations make up >50% of all dislocations in the body

·         Anterior / subcoracoid shoulder dislocation (96%)

·         Mechanism

o       External rotation and abduction and external rotation

·         Age

o       Younger individuals

·         May be associated with

o       Hill-Sachs defect (50%) is a depression fracture of posterolateral surface of humeral head from impaction of the head against glenoid rim in subglenoid type

§         Best demonstrated on the AP projection with the arm internally rotated

o       Bankart lesion is a fracture of anterior aspect of inferior glenoid rim

§         Only cartilaginous portion of glenoid labrum may be fractured which may only be visible on MRI

o       Fracture of greater tuberosity (15%)

·         Complications

o       Recurrent dislocations (40%)

o       Post-traumatic arthritis

o       Injury to axillary nerve or artery

 

 

 

 

Anterior Dislocation of the Humeral Head: Top image shows humeral head displaced from glenoid
and lying inferior to the coracoid process (red arrow); the middle image demonstrates a defect along the posterolateral aspect of the head, which is the Hill-Sach's deformity (green arrow). The lower image is the scapular Y view (blue line outlines scapula). The head lies in a subcoracoid (i.e. anterior location).
The white arrows point to the acromion.

For the same photo with out the arrows, click here

 

 

Dahnert 4th edition
Orthopedic Radiology, Adam Greenspan