What is Hill-Sachs fracture & Bankart lesion?
As a result of an anterior shoulder dislocation, Hill-Sachs fracture & Bankart lesion may occur in the shoulder.
There is a compression fracture on the Posterosuperolateral humeral head that is a Hill-Sach fracture. Anteroinferior glenoid rim inflammation is the result of forceful impaction of the humeral head.
Associated with Bankart lesions is a detachment or injury of the anterior inferior glenoid labrum.
Both kinds of injuries are common in sports (such as volleyball, Tennis, Handball), people who do overhead activities, fall with outstretched arms, assaults, throwing, people having a history of previous dislocations.
The person with hill-Sach fracture and Bankart lesion present with an arm held in abduction and external rotation, loss of normal contour of the deltoid and acromion prominent posteriorly and laterally, humeral head palpable anteriorly, all movement limited and painful. Pain is not localized at a specific point and the pain gets worse when the arm is held behind the back, weakness & instability of the shoulder.
Hill-Sach or Bankart repair surgery requires early physiotherapy rehabilitation. As there is a chance of reoccurrence, contracture, muscle weakness, less joint mobility, and poor activity of daily living
PHYSIOTHERAPY MANAGEMENT & REHABILITATION AFTER SURGERY OF BANKART LESION & HILL-SACHS FRACTURE
Firstly, The aim of physiotherapy is to prevent the reoccurrence of dislocation.
Secondly, Early on in the rehabilitation process, abduction & external rotation are restricted.
First Phase of rehabilitation (0 to 4 weeks).
Sling immobilization with limited active ROM for 0 to 4 weeks.
Passive ROM exercise in pain-free range (after 14 days).
Isometric strengthening exercise for Rotator cuff muscle in close chain exercise (after 7 days).
Second Phase of rehabilitation (3 to 10 weeks).
Progressive passive ROM exercise with Active Assisted ROM exercise.
Pendulum exercises.
Strengthening exercise of the rotator cuff with resisted band or dumbbell in open-chain exercise.
Third Phase of rehabilitation (6 to 16 weeks).
Upon normal passive ROM, continue to phase 3. It aims to restore full active ROM.
Progressively increasing resistance in dynamic exercise.
Scapula stabilization exercises.
Plyometric exercises.
Also, controlled falling drills.
Following, return to full contact training.
Finally, Return to sports training.