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Do Reduction and Healing of the Bony Fragment Really Matter in Arthroscopic Bony Bankart Reconstruction?: A Prospective Study With Clinical and Computed Tomography Evaluations.
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- Author(s): Jiang, Chun-Yan; Zhu, Yi-Ming; Liu, Xin; Li, Feng-Long; Lu, Yi; Wu, Guan
- Source:
American Journal of Sports Medicine. Nov2013, Vol. 41 Issue 11, p2617-2623. 7p. - Source:
- Additional Information
- Subject Terms: ARTHROSCOPY; CONFIDENCE intervals; FRACTURE fixation; BONE fractures; JOINT hypermobility; RANGE of motion of joints; LIFE skills; LONGITUDINAL method; ORTHOPEDIC implants; HEALTH outcome assessment; RESEARCH evaluation; RESEARCH funding; ROTATIONAL motion; SHOULDER injuries; SHOULDER joint injuries; STATISTICS; T-test (Statistics); TOMOGRAPHY; WOUND healing; WOUNDS & injuries; TREATMENT effectiveness; INTER-observer reliability; DATA analysis software; FUNCTIONAL assessment; DESCRIPTIVE statistics
- Subject Terms:
- Abstract: Background:Bony Bankart lesions can be treated with arthroscopic repair. However, few studies have evaluated the importance of bony fragment reduction and healing to stability of the glenohumeral joint after arthroscopic bony Bankart repair.Purpose:To evaluate functional results after surgery and determine the correlation between reduction and healing of the fracture and postoperative stability of the glenohumeral joint.Study Design:Case series; Level of evidence, 4.Methods:A total of 50 patients (47 men, 3 women; average age, 27.6 years; range, 16.5-50.1 years) with bony Bankart lesions and recurrent anterior shoulder dislocations were treated with arthroscopic reduction and internal fixation with suture anchors. The average follow-up period was 32.5 months (range, 24.3-61.2 months). Preoperative and postoperative range of motion and American Shoulder and Elbow Surgeons (ASES), Constant-Murley, and Rowe scores were compared to evaluate the results of the surgeries. Sequential 3-dimensional computed tomography (CT) scans were available for 37 patients and were analyzed to investigate the effect of the bony defect of the glenoid and the correlation between the success of the surgery and reduction and healing of the bony fragment.Results:After surgery, active forward elevation was significantly improved (P < .05). No significant differences were found regarding external and internal rotations after surgery. The ASES, Constant-Murley, and Rowe scores improved significantly after surgery. Redislocations occurred in 3 patients, and a positive anterior apprehension sign was detected in 1 patient during follow-up. The overall failure rate was 8.0% (4/50). The CT scans during the follow-up period showed a nonunion of the bony fragment in 13.5% of cases (5/37). The reconstructed size of the glenoid was <80% in 3 of the 4 failure cases but >80% in all of the successful cases.Conclusion:Arthroscopic reduction and fixation of a bony Bankart lesion can achieve good results in selected cases. The size of the reconstructed glenoid is crucial to the success of the surgery. [ABSTRACT FROM AUTHOR]
- Abstract: Copyright of American Journal of Sports Medicine is the property of Sage Publications Inc. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
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