Hill-Sachs lesion


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[Harold Arthur Hill, U.S. radiologist, 1901-1973; Maurice David Sachs, U.S. radiologist, 1909-1987]
An osteochondral fracture of the posterolateral humeral head that occurs following an anterior dislocation of the glenohumeral joint.

A Hill-Sachs lesion occurs in about 40% of all first-time anterior shoulder dislocations and up to 80% of recurrent dislocations. The relative size of the lesion, as determined through an arthroscope or diagnostic imaging, can be used to ascertain the relative magnitude of the original dislocation.

The lesion involves the cartilage of the humeral head, causing instability that may predispose the individual to subsequent anterior glenohumeral dislocations. Although many Hill-Sachs lesions are asymptomatic, pain may arise from the posterolateral humeral head when the glenohumeral joint is abducted to 90° and passive external rotation is applied.

Surgical repair may be needed to increase anterior stability of the glenohumeral joint.

After a Hill-Sachs lesion is repaired, physical therapy is required to strengthen the ligaments that hold the head of the humerus in the glenoid and to improve pain tolerance and shoulder flexibility.

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