The Hill-Sachs lesion. An experimental study.

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 detecting Hill-Sachs lesions include the following three roentgenograms: anteroposterior view of the glenohumeral joint with the humerus in 45 degrees internal rotation, the notch (Stryker) view, and the modified Didiee view.