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Arthroscopic Bony Bankart Repair for Traumatic Shoulder Dislocation

February 10, 2018

Contributors: Amos Dai, BS; James Liu, MD; Dylan Lowe, MD; Hien Pham, MD; Michael Pickell, MD; Andrew S Rokito, MD; Michael A Zacchilli, MD; Laith M Jazrawi, MD; Laith M Jazrawi, MD

Keywords: Bony Procedure

Purpose: Bony Bankart injuries are avulsion fractures of the glenoid rim that are usually a result of a traumatic glenohumeral dislocation. The resulting osseous defect can cause recurrent glenohumeral instability, leading to erosion of the glenoid rim and progressive instability. Patients may experience pain, stiffness, weakness, and impaired function of the shoulder. Orthopaedic surgeons must understand the multifactorial preoperative considerations that guide surgical management, and be comfortable utilizing a variety of fixation techniques when approaching these clinically challenging cases. The purpose of this video compilation is to present glenoid osseous defects that cause shoulder instability, describe the exam and diagnosis findings, identify the appropriate treatment strategy, and illustrate appropriate surgical technique in the surgical management of bony Bankart lesions.

Methods: We present a compilation of three cases of traumatic bony Bankart lesions resulting in glenohumeral instability indicated for surgical repair and bony stabilization. Patient history, physical exam findings, radiographs, and advanced imaging are demonstrated. The videos review the important preoperative considerations for each patient, appropriate portal sites for each surgery, illustrate arthroscopic technique, suture choice, anchor placement, and describe postoperative outcomes for each bony Bankart defect repair.

Results: Postoperative follow up at different time points are reviewed, and postoperative imaging is demonstrated. The patients in this series were progressing well with 5/5 strength in forward elevation, external rotation, and internal rotation. Greater than 120-degree active forward elevation was achieved in all patients, and instability was resolved. Return to rigorous physical activity without symptoms of pain or instability was achieved in all patients.

Conclusion: Bony Bankart lesions are challenging clinical injuries that require a variety of fixation techniques depending on the injury and exam findings. These cases demonstrate effective means to restore glenohumeral stability using a variety of arthroscopic techniques, which provides surgeons with reproducible methods to address bony Bankart lesions efficiently, while minimizing error and improving patient outcomes.

Results for "Shoulder: Rotator Cuff/Subscap"

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