Case of the Month - April 2020
Bony Bankart Injury with Arthroscopic Fixation/Repair
Case: 39-year-old male police officer with Right anterior shoulder dislocation after a fall. X-rays, MRI and CT scan imaging revealed a displaced bony Bankart injury (anterior glenoid fracture with associated capsulolabral injury). Prompt surgical treatment of these injuries is recommended to achieve best outcomes. Therefore, given the size and displacement of the glenoid bone fragment and risk of future instability events secondary to glenoid bone loss, the patient elected to proceed with surgery. The patient underwent an arthroscopic double-row bony Bankart fixation/repair with 2-point fixation and compression and additional labral repair on either side of the fracture utilizing a total of four knotless suture anchors.
The shoulder is a ball and socket joint, and the labrum is a tissue around the glenoid (socket) that deepens the socket, making it a stronger fit for the humeral head (ball). https://www.orthoinfo.org/en/diseases--conditions/shoulder-joint-tear-glenoid-labrum-tear/
Axial (left) and sagittal (right) MRI images demonstrating a large, displaced bony Bankart fragment with associated capsulolabral injury.
Axial (left) and 3D reformatted coronal (right) images demonstrating a medially displaced bony Bankart fracture fragment with significant compromise of the anteroinferior glenoid.
Arthroscopic view of initial fracture mobilization of the bony fragment partially healed to the glenoid neck (left). Bony Bankart fragment adequately mobilized and double loaded suture anchor placed into glenoid neck medial to the fragment.
Arthroscopic images demonstrating suture passage around the mobilized and elevated bony Bankart fragment.
Final arthroscopic images showing final repair with suture anchors placed up onto the glenoid face and reduction of the bony fragment with additional labral repair. Note that the humeral head is centered over the glenoid (right).