scholarly journals Treatment of chronic anterior shoulder dislocation by open reduction and simultaneous Bankart lesion repair

Author(s):  
Alireza Rouhani ◽  
Amirmohammad Navali
2017 ◽  
Vol 11 (1) ◽  
pp. 327-334 ◽  
Author(s):  
Konstantinos Pantazis ◽  
Andreas Panagopoulos ◽  
Irini Tatani ◽  
Basilis Daskalopoulos ◽  
Ilias Iliopoulos ◽  
...  

Background: Failure of closed manipulative reduction of an acute anterior shoulder dislocation is seldom reported in the literature and is usually due to structural blocks such as soft tissue entrapment (biceps, subscapularis, labrum), bony fragments (glenoid, greater tuberosity) and severe head impaction (Hill-Sachs lesion). Case report: We present a case of an irreducible anterior shoulder dislocation in a 57-year-old male patient after a road-traffic accident. He had severe impaction of the head underneath glenoid rim and associated fracture of the greater tuberosity. Closed reduction performed in the emergency room under sedation and later at the theatre under general anaesthesia was unsuccessful. Open reduction using the dectopectoral approach revealed that the reason for obstruction was the posterolateral entrapment of the biceps tendon between the humeral head and the tuberosity fragment. Reduction was achieved after subscapularis tenotomy and opening of the joint; the tuberosity fragment was fixed with transosseous sutures and the long head of the biceps tendon was tenodesized. The patient had an uneventful postoperative recovery and at his last follow up, 12 months postoperatively, he had a stable joint, full range of motion and a Constant score of 90. Conclusion: A comprehensive literature review revealed 22 similar reports affecting a total of 30 patients. Interposition of the LHBT alone or in combination with greater tuberosity fracture was the most common obstacle to reduction, followed by subscapularis tendon interposition and other less common reasons. Early surgical intervention with open reduction and confrontation of associated injuries is mandatory for a successful outcome.


2021 ◽  
Vol 16 (1) ◽  
pp. 34-40
Author(s):  
B. Schliemann ◽  
F. Dyrna ◽  
V. Kravchenko ◽  
M. J. Raschke ◽  
J. C. Katthagen

Abstract Introduction Traumatic anterior shoulder dislocation occurs frequently and usually affects young, active male patients. Detachment of the anteroinferior labrum, known as the Bankart lesion, is a common result. However, more extensive entities including bony lesions and disruptions of the labral ring can also be found. The aim of the present work was to analyze all cases of first-time traumatic anterior shoulder dislocation at a level‑1 trauma center with regard to the type of labral lesion. Focus was placed on the frequency and distribution of complex lesions and the extent of the surgical repair. Patients and methods The clinical database of a level‑1 trauma center with a specialized shoulder unit was searched to identify all patients with first-time anterior shoulder dislocation treated between 2015 and 2019. Of 224 patients, 110 underwent primary surgical repair after first-time dislocation (mean age 40 years). Results A total of 62% of patients had only a soft tissue injury, while 38% (n = 40) showed a bony Bankart lesion/fracture of the glenoid fossa with a mean defect size of 26%. In only 31% of patients (n = 34), a classic Bankart repair was performed, whereas the remaining 69% underwent additional procedures. Conclusion In this series of surgically treated first-time traumatic anterior shoulder dislocations, the majority of cases presented with more complex lesions than an isolated classic Bankart lesion. The risk for bony involvement and associated pathologies, such as cuff tears and greater tuberosity fracture, increases with age and requires a more extensive surgical approach. Disruption of the labral ring was frequently found in both soft tissue and bony lesions and directly affected the surgical procedure.


2014 ◽  
Vol 8 (1) ◽  
pp. 457-461 ◽  
Author(s):  
C. Tudisco ◽  
S. Bisicchia ◽  
E. Savarese ◽  
E. Ippolito

Background: There is still debate about the best treatment option for highly recurrent anterior shoulder dislocation in patients with severe impairment of the anterior capsule and/or recurrence after either arthroscopic or open capsulorrhaphy. Materials and Methods: The clinical and radiological findings of 7 patients treated with an open capsulorrhaphy stabilized with an “8 plate” for a highly recurrent traumatic anterior shoulder dislocation with severe impairment of the anterior capsule and a large Bankart lesion were retrospectively reviewed. Follow-up evaluation included VAS for pain, Constant-Murley, Simple Shoulder Test, ASES, UCLA, Quick DASH, Rowe, Walsch-Duplay scores, as well as X-rays of the operated shoulder. Results: At follow-up none of the patients reported subsequent dislocations. Range of motion of the shoulder was complete in all cases, but one. Results of the functional scoring systems were satisfactory. X-rays showed no osteolysis and good position of the plate. Conclusion: To our knowledge, this is the first report in the literature about an open capsular tensioning and Bankart lesion repair performed with an “8 plate”. We believe that this is a reliable and effective procedure to address traumatic anterior re-dislocation of the gleno-humeral joint when the capsule is extensively torn and frayed or in revision cases. Moreover the “8 plate” is ideal to be applied in such a narrow space on the slant surface of the scapular neck close to the glenoid rim.


2021 ◽  
Vol 11 (5) ◽  
Author(s):  
Anurag Rana ◽  
Sukhmin Singh ◽  
Lakshmana Das ◽  
Nagaraj Manju Moger ◽  
Lakshya Prateek Rathore ◽  
...  

Introduction: Anterior shoulder dislocation is a common presentation in orthopedic emergency but a bilateral fracture dislocation is a rare entity. Only a few cases have been reported in the literature and their management is still not clear. We present a bilateral four part fracture dislocation with Bankart lesion on right side in a 48 years old. Case Report: A 48-year-old male presented with bilateral proximal humerus fracture with anterior shoulder dislocation following a seizure. He was managed with bilateral PHILOS and Latarjet procedure on right side for a chronic bony Bankart lesion. Superficial infection on left side was managed with debridement. After 1 year period patient had a satisfactory outcome with DASH score of 19.2. Conclusion: Bilateral four part proximal humerus fracture with shoulder dislocation is encountered rarely. Recurrent dislocations results in chronic glenoid bones loss which needs fixation along with fracture. Addressing both sides subsequently or in a single sitting is still debatable. Keywords: Bilateral humerus fracture, anterior dislocation, Bankart repair.


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