Abstract
Objectives:
Bankart lesion is a form of recurrent instability commonly seen on traumatic shoulder dislocation. The treatment itself presents with challenges for both operative and non-operative procedures. The study reviews management outcomes for operative and non-operative procedure in preventing recurrency of shoulder dislocation.
Methods:
The study reviewed articles presenting of traumatic anterior shoulder dislocation due to Bankart lesion with either operative or non-operative management. The database used was PubMed. The outcomes of management were divided into operative outcomes and non-operative outcomes. Outcomes including recurrency, times to heal, and infection were reviewed for each type of management.
Results:
Both operative and non-operative management had recurrency. While operative management had less recurrency rate, the techniques applied and coexisting pathology may provide bigger recurrency rate. Open Bankart repair procedure showed the most desirable outcomes with minimal recurrency rate. Open Bankart with remplissage also showed good outcomes but post-operative loss of external rotation and residual pain must be considered to the patient’s wellbeing. The mean follow up time for all operative procedures were not significantly different with the mean follow up time ranging from 40 to 50 months. Infection rates on operative procedure were also minimal with all post-operative treatment. While non-operative management also viable to treat traumatic anterior shoulder dislocation due to Bankart lesion, the recurrency rate were significantly higher than operative management and could not be applied on patients with bone loss.
Conclusion:
Managing recurrent traumatic anterior shoulder dislocation due to Bankart lesion needs operative procedures to achieve higher desirable outcomes. The techniques are varied and patients with multiple coexisting pathology need multiple operative procedure. While there are patients with recurrence after taking operative procedures, it is still considered to be better than managing with non-operative procedures on patients with existing recurrency. There is no guideline available for the injury but open Bankart repair showed the most desirable outcomes with minimal post-operative side effects. Study also showed other techniques to be viable and showed desirable outcomes but the post-operative effects must be considered to patient’s wellbeing.