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Mini Board Review: July 2013 Edition

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#2

THE ANSWER IS D.

A Hill-Sachs deformity is the most common complication of an anterior shoulder dislocation, occurring in up to 40% of cases. The defect is a depression fracture of the posterolateral surface of the humeral head that results from compression of the dislocated head by the lower glenoid rim. Prolonged dislocation leads to larger deformity size. Not surprisingly, a Hill-Sachs defect is also more likely with recurrent anterior dislocations.

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altBrachial plexus injury or damage to the axillary nerve (A) occurs in up to 14% of anterior shoulder dislocations. Axillary nerve injury is usually a neuropraxia and complete recover is expected. A Bankart lesion (B) is a fracture of the anterior aspect of inferior glenoid rim and occurs between 10% and 20% of traumatic anterior shoulder dislocations. Fracture of the greater tuberosity (C) occurs in up to 15% of anterior dislocations.

Reference

Simon RR, Sherman SC: Knee, in Simon RR, Sherman SC (eds): Emergency Orthopedics, ed 6. New York, The McGraw-Hill Companies Inc., 2011, (Ch) 16:p 343-346

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