Clinical Presentation & Protocol
Patient Usually Complains Of
Patient presents with a history of anterior shoulder instability following a traumatic dislocation event. Reports persistent clicking, catching, and a sensation of "giving way" during overhead activities. Pain is localized to the posterior-superior aspect of the humeral head, exacerbated by abduction and external rotation.
Clinical Examination Findings
Physical examination reveals positive apprehension sign and relocation test. Palpation of the humeral head demonstrates tenderness. Range of motion is limited by apprehension in the provocative position. Neurovascular status is intact distally. Imaging (MRI/CT) confirms a cortical impaction fracture of the posterolateral humeral head consistent with a Hill-Sachs lesion.
Treatment Protocol
Initial management includes activity modification, avoidance of provocative overhead maneuvers, and a structured physical therapy program focusing on rotator cuff strengthening and scapular stabilization. If instability persists or the lesion is engaging, surgical intervention (e.g., Remplissage procedure or arthroscopic stabilization) is indicated.