Reverse bankart and hill sachs lesions Anterior humeral impaction fracture of the lesser tuberosity and posterior labrum tear. The periosteum of the scapula looks intact so maybe should be called a reverse Perthes lesion. Injury occurs when a posterior force occurs to the shoulder (front to back) when the shoulder is internally rotated and flexed. Classic examples are tonic clonic seizure with the patient falling with decorticate rigidity forward and hitting the ground. Also American football lineman in 3 point stance (internal rotation and some flexion) hit by another player moving towards him when the ball is hiked. Typically the other player is as large as a refrigerator.