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The Hill-Sachs lesion

An experimental study

Division of Orthopaedic Surgery, the Department of Radiology, University Hospital, University of California, San Diego, School of Medicine, and Veterans Administration Medical Center, San Diego, California

Guerdon Greenway, M.D.

Division of Orthopaedic Surgery, the Department of Radiology, University Hospital, University of California, San Diego, School of Medicine, and Veterans Administration Medical Center, San Diego, California

Donald Resnick, M.D.

Division of Orthopaedic Surgery, the Department of Radiology, University Hospital, University of California, San Diego, School of Medicine, and Veterans Administration Medical Center, San Diego, California,

The Hill-Sachs lesion is an important indication of previous anterior shoulder dislocation. We created Hill-Sachs lesions by using cadaveric humeri. Roentgenographs of these cadaveric humeri in the standard projections were then taken. Under fluoroscopy, new projections of the cadaveric humeri were obtained. In a clinical study, 15 patients (14 men and 1 woman; age range, 23 to 63 years; mean, 30 years) with known recurrent anterior shoulder dislocations were evaluated by using standard and new roentgenographic projections. On the basis of the cadaveric and clinical studies, the optimal methods for detect ing Hill-Sachs lesions include the following three roentgeno grams : anteroposterior view of the glenohumeral joint with the humerus in 45° internal rotation, the notch (Stryker) view, and the modified Didiee view.

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