The shoulder is the most mobile and the most commonly dislocated large joint in the body. A dislocation occurs when the joint is moved out of position so that the joint surfaces at the ends of the bones are no longer in contact. When a shoulder dislocation occurs, the soft tissues that stabilize the shoulder can be torn, and the bone that forms the socket can also be broken.
What Is a Bony Bankart Lesion?
Traumatic dislocations of the shoulder can result in a Bankart lesion (tear). The head of the humerus (ball of the upper arm bone) is held in proper relation to the glenoid (socket of the shoulder joint) by the rotator cuff muscles, labrum, and ligaments.
When the humeral head is forced forward in a dislocation, the soft tissues stretch or tear. In some cases, bone is fractured off the glenoid rim, resulting in a bony Bankart lesion.
Causes and Risk Factors
Causes include:
- A direct blow to the shoulder or force on an extended arm
- Powerful, violent muscle contraction
- Force applied to the arm in an overhead position, pushing it behind the plane of the body
Risk factors include:
- Participation in contact sports such as football, wrestling, and basketball
- Activities with an increased risk of falls or injury
- Previous shoulder dislocations or injuries
- Poor physical conditioning, including strength and flexibility
Symptoms
Signs and symptoms may include:
- Severe shoulder pain at the time of injury
- Loss of function and pain with shoulder motion
- Apprehension or a feeling that the shoulder is going to “pop out”
- Occasional aching when not using the arm
- Tenderness and swelling
- Occasional loss of strength or difficulty raising the arm
- Occasional numbness and tingling in the arm after injury
Treatment
After the joint is reduced (put back into place) by trained medical personnel, treatment consists of ice, medications, and early mobilization if the fracture is small. MRI or CT scans may be necessary to determine the size of the fracture and the need for surgery.
If the bony Bankart fracture is significant in size, the shoulder will remain unstable without surgical repair. Displaced, large bony Bankart fractures require surgery to reposition and stabilize the fragments.
Most fractures require open surgery to be treated effectively. However, Dr. Chudik developed special instruments and techniques to repair these bony fractures arthroscopically.
Recovery and Outcomes
It is possible to use conservative measures to allow the shoulder to recover and increase muscular stability through exercises. However, if the bony Bankart fracture is significant in size, the shoulder will remain unstable without surgical repair.
Dr. Chudik may recommend an arthroscopic procedure to address the bony Bankart lesion and any other injuries that may have occurred with the dislocation.
Following surgery, the shoulder is immobilized in a sling for six weeks to allow the repaired tissue to heal. Most patients experience full recovery and return to activities within four to six months after surgery.
When to See Dr. Chudik
Notify Dr. Chudik’s office if symptoms worsen. Call 630-324-0402, request an appointment online, or email contactus@chudikmd.com.