Why is this different from a more typical Hill-Sachs lesion?
From a similar mechanism of the greater tuberosity being damaged in an anterior dislocation, Hill Sachs lesions are typically impaction injury to the humeral head, rather than displaced fractures. Some are demonstrable on plain film, or require cross-sectional imaging to identify if suspected.
What other structure should be particularly inspected for injury?
The inferior rim of the glenoid fossa should be reviewed for a Bankart lesion, following impact in the dislocation. Again, CT or MR may be required to inspect for soft-tissue damage.
Why is careful identification needed in post-ictal patients?
These patients are at greater risk of posterior dislocation, with the force of seizure and stress on the joint being enough to "pop" out of the bony protection of the scapula. However it is important to remember that anterior dislocations are easier and still going to be more common.
Right shoulder dislocation with a displaced greater tuberosity fracture.
Right internal jugular central venous catheter with the tip projecting over the SVC. No pneumothorax or lung pathology.