Contact between the glenoid and the humeral head in abduction, external rotation, and horizontal extension: a new concept of glenoid track

J Shoulder Elbow Surg. 2007 Sep-Oct;16(5):649-56. doi: 10.1016/j.jse.2006.12.012. Epub 2007 Jul 23.


To date, no anatomic or biomechanical studies have been conducted to clarify what size of a Hill-Sachs lesion needs to be treated. Nine fresh-frozen cadaveric shoulders were tested in a custom device. With the arm in maximum external rotation, horizontal extension, and 0 degrees, 30 degrees, and 60 degrees of abduction, the location of the entire rim of the glenoid was marked on the humeral head using a Kirschner wire. The distance from the contact area to the footprint of the rotator cuff with the arm in 60 degrees of abduction was measured by a digital caliper. With an increase in arm elevation, the glenoid contact shifted from the inferomedial to the superolateral portion of the posterior aspect of the humeral head, creating a zone of contact (glenoid track). The medial margin of the glenoid track was located 18.4 +/- 2.5 mm medial from the footprint, which was equivalent to 84% +/- 14% of the glenoid width. A Hill-Sachs lesion has a risk of engagement and dislocation if it extends medially over the medial margin of the glenoid track.

MeSH terms

  • Aged
  • Cadaver
  • Female
  • Humans
  • Imaging, Three-Dimensional
  • Male
  • Middle Aged
  • Range of Motion, Articular / physiology*
  • Rotation
  • Sensitivity and Specificity
  • Shoulder Joint / anatomy & histology*
  • Shoulder Joint / physiology*
  • Tomography, X-Ray Computed