Techniques in Hand & Upper Extremity Surgery. 21(2):60–66, JUN 2017
DOI: 10.1097/BTH.0000000000000151
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PMID: 28441305
Issn Print: 1089-3393
Publication Date: 2017/06/01
Step-by-Step Technique for Segmental Reconstruction of Reverse Hill-Sachs Lesions Using Homologous Osteochondral Allograft
Hassanin Alkaduhimi;Michel van den Bekerom;Derek van Deurzen;
+ Author Information
Shoulder and Elbow Unit, Onze lieve Vrouwe Gasthuis, Amsterdam, The Netherlands
Abstract
Posterior shoulder dislocations are accompanied by high forces and can result in an anteromedial humeral head impression fracture called a reverse Hill-Sachs lesion. This reverse Hill-Sachs lesion can result in serious complications including posttraumatic osteoarthritis, posterior dislocations, osteonecrosis, persistent joint stiffness, and loss of shoulder function. Treatment is challenging and depends on the amount of bone loss. Several techniques have been reported to describe the surgical treatment of lesions larger than 20%. However, there is still limited evidence with regard to the optimal procedure. Favorable results have been reported by performing segmental reconstruction of the reverse Hill-Sachs lesion with bone allograft. Although the procedure of segmental reconstruction has been used in several studies, its technique has not yet been well described in detail. In this report we propose a step-by-step description of the technique how to perform a segmental reconstruction of a reverse Hill-Sachs defect.
