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

BMC Musculoskeletal Disorders

Paavo Rillmann¹  Pierre Hepp²  Christian Ryf¹  Ulrich J A Spiegl² 

[1] Department of Surgery, Davos Hospital, Promenade 4, Davos Platz, 7270, Switzerland;Department of Trauma and Reconstructive Surgery, University of Leipzig, Liebigstr 20, Leipzig, 04103, Germany

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

Others  :  1129379
DOI  :  10.1186/1471-2474-14-305

 received in 2013-04-12, accepted in 2013-10-09,  发布年份 2013

【 摘 要 】

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: p = 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.

【 授权许可】

   
2013 Spiegl et al.; licensee BioMed Central Ltd.

【 图 表 】

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