Email updates

Keep up to date with the latest news and content from BMC Musculoskeletal Disorders and BioMed Central.

Open Access Research article

Evaluation of a treatment algorithm for acute traumatic osseous Bankart lesions resulting from first time dislocation of the shoulder with a two year follow-up

Ulrich J A Spiegl12*, Christian Ryf1, Pierre Hepp2 and Paavo Rillmann1

Author Affiliations

1 Department of Surgery, Davos Hospital, Promenade 4, Davos Platz, 7270, Switzerland

2 Department of Trauma and Reconstructive Surgery, University of Leipzig, Liebigstr 20, Leipzig, 04103, Germany

For all author emails, please log on.

BMC Musculoskeletal Disorders 2013, 14:305  doi:10.1186/1471-2474-14-305

Published: 25 October 2013

Abstract

Background

Studies dealing with acute osseous Bankart lesions and corresponding treatment strategies are rare. The purpose of this study is to analyze the results after applying our treatment algorithm for acute glenoid rim fractures caused by first time traumatic anterior shoulder dislocations.

Methods

25 patients were included in this retrospective case series. All patients sustained a first time shoulder dislocation caused by ski or snowboard accidents. An osseous Bankart lesion was detected in all shoulders. Operative therapy was performed in patients with osseous defects of 5% or more, otherwise conservative therapy was initiated. Primary study outcome parameter was the Rowe score. Additionally, the outer rotation deficit and operative complications were analysed.

Results

12 patients showed a defect size of less than 5% and were treated conservatively. The average lesion size was 2%. For these patients, the Rowe score was excellent in 58%, good in 25%, and moderate in 17% of patients. Three patients (25%) complained about a feeling of instability. 13 patients had a lesion size of more than 5%, average 15%, and were treated operatively. The Rowe score for this group was excellent in 54%, good in 31%, and moderate results in 15% of patients. One patient (8%) complained about a feeling of instability, without recurrent dislocations. There were no statistically significant differences between both study groups (ROWE score: pā€‰=ā€‰0.98).

Conclusions

Applying our treatment algorithm for acute osseous Bankart lesions consisting of a conservative strategy for small defect sizes and a surgical approach for medium-sized and large defects leads to encouraging mid-term results and a low rate of recurrent instability in active patients.

Keywords:
Glenoid rim fracture; Osseous Bankart lesion; Anterior shoulder dislocation; Operative treatment strategy; Conservative treatment