Lesão de Hill-Sachs: Diagnóstico, classificação e tratamento

Resumo

A lesão de Hill-Sachs é uma condição frequentemente associada à instabilidade anterior do ombro, que desempenha um papel crucial nos resultados de seu tratamento. É caracterizada por uma fratura compressiva posterior na cabeça do úmero, que resulta do impacto contra a borda anterior da cavidade glenoidal durante um episódio de luxação. A compreensão aprofundada dessa lesão é essencial para embasar decisões clínicas e para a escolha do tratamento mais adequado. Com os avanços nas modalidades de imagem, como a ressonância magnética e a tomografia computadorizada, tornou-se possível identificar a presença da lesão com maior precisão e classificá-la de acordo com sua profundidade, localização e volume, o que possibilita uma avaliação mais detalhada do seu papel na instabilidade do ombro. Este artigo revisa as principais classificações, métodos de diagnóstico e opções de tratamento, com o objetivo de fornecer ao ortopedista uma visão abrangente e atualizada das estratégias que promovem melhores desfechos funcionais e minimizam o risco de recorrência da instabilidade.

Abstract

A lesão de Hill-Sachs é uma condição frequentemente associada à instabilidade anterior do ombro, que desempenha um papel crucial nos resultados de seu tratamento The Hill-Sachs lesion is a condition frequently associated with anterior shoulder instability, which plays a crucial role in the outcomes of its treatment. It is characterized by a posterior compressive fracture in the humeral head caused by an impingement against the anterior rim of the glenoid cavity during dislocation. A thorough understanding of this lesion is essential to support clinical decisions and choose the most appropriate treatment. Advances in imaging modalities, such as magnetic resonance imaging and computed tomography, enabled lesion identification with greater precision and its classification per depth, location, and volume, resulting in a detailed assessment of its role in shoulder instability. The present article reviews the main classifications, diagnostic methods, and treatment options to provide orthopedists with a comprehensive and updated view of the strategies to promote better functional outcomes and minimize the risk of instability recurrence.

Palavras-chave

fratura do úmero - instabilidade articular - luxação do ombro - procedimentos ortopédicos

Keywords

humeral fractures - joint instability - orthopedic procedures - shoulder dislocation

Contribuições dos Autores

Cada autor contribuiu individual e significativamente para o desenvolvimento deste artigo. MJST: conceptualização, análise formal, investigação, metodologia e redação – revisão & edição. AYU e RAZ: redação – preparação do original, redação – revisão & edição, validação e visualização. FTM: análise formal, investigação, metodologia e redação – revisão & edição. NAN: conceptualização, análise formal e curadoria de dados.

Publication History

Received: 02 November 2024

Accepted: 07 March 2025

Article published online:
10 July 2025

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