Bankart, Br Med J 1923 - Recurrent or Habitual Dislocation of the Shoulder-Joint

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Recurrent or Habitual Dislocation of the Shoulder-Joint

Bankart·Br Med J·1923·700 citations·Case series

Free Full Text·DOI·PubMed

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Bankart challenges the prevailing view that recurrent shoulder dislocation stems from a lax capsule or weak muscles. Based on four operative cases, he identifies detachment of the capsule and labrum from the anterior glenoid rim as the essential lesion. He describes a surgical exposure and repair that reattaches the tissue to the rim.

Key Findings

The essential lesion is detachment of the capsule and labrum from the anterior glenoid rim, later known as the Bankart lesion. This reframed recurrent instability as a discrete structural defect, not diffuse laxity.
Detachment spans the entire anterior half of the glenoid rim, and the torn tissue has no tendency to reunite with fibrocartilage. The defect is therefore permanent, allowing the humeral head to slip forward on slight provocation.
The recurrent injury is caused by a direct backward drive on the shoulder or elbow, not the abduction-leverage fall that produces a first-time dislocation. This distinction explains why athletes and epileptics who fall with arms adducted are affected.
Bony fractures of the anterior glenoid or greater tuberosity may coexist but are incidental, not essential, to the pathology.
Repair reattaches the capsulolabral tissue to a freshened glenoid rim with interrupted silkworm gut sutures, after taking down the coracoid and subscapularis for exposure.
Of 4 operated cases, 3 regained full motion with zero recurrences. The single poor result was an epileptic who neglected postoperative rehabilitation.

Board PearlRecurrent anterior shoulder dislocation is caused by capsulolabral detachment from the anterior glenoid rim, not capsular laxity, and is repaired by reattaching it.

Recurrent or Habitual Dislocation of the Shoulder-Joint.

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Effects of Bracing in Adolescents with Idiopathic Scoliosis.

Weinstein, Dobbs, et al.N Engl J Med20131,160 citationsRCT

Adolescent Idiopathic Scoliosis: A New Classification to Determine Extent of Spinal Arthrodesis.

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Problems in the Management of Type III (Severe) Open Fractures: A New Classification of Type III Open Fractures.

Gustilo, Williams, et al.J Trauma19842,361 citationsRetrospective cohort

Neer Award 2005: The Grammont Reverse Shoulder Prosthesis: Results in Cuff Tear Arthritis, Fracture Sequelae, and Revision Arthroplasty.

Boileau, Hovorka, et al.J Shoulder Elbow Surg20061,115 citationsProspective cohort

A System for the Surgical Staging of Musculoskeletal Sarcoma.

Enneking, Goodman, et al.Clin Orthop Relat Res19802,112 citationsRetrospective cohort

Fracture Fixation in the Operative Management of Hip Fractures (FAITH): An International, Multicentre, Randomised Controlled Trial.

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Fatty Muscle Degeneration in Cuff Ruptures. Pre- and Postoperative Evaluation by CT Scan.

Goutallier, Voisin, et al.Clin Orthop Relat Res19942,669 citationsProspective cohort

Dislocations after Total Hip-Replacement Arthroplasties.

Lewinnek, Zimmerman, et al.J Bone Joint Surg Am19782,549 citationsRetrospective cohort

Morphologic Study of the Glenoid in Primary Glenohumeral Osteoarthritis.

Walch, Khoury, et al.J Arthroplasty19991,142 citationsRetrospective cohort

The Three Column Spine and Its Significance in the Classification of Acute Thoracolumbar Spinal Injuries.

DenisSpine (Phila Pa 1976)19832,566 citationsRetrospective cohort

The Reverse Shoulder Prosthesis for Glenohumeral Arthritis Associated with Severe Rotator Cuff Deficiency. A Minimum Two-Year Follow-Up Study of Sixty Patients.

Frankle, Vasey, et al.J Bone Joint Surg Am2005773 citationsRetrospective cohort

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A New Classification of Thoracolumbar Injuries: The Importance of Injury Morphology, the Integrity of the Posterior Ligamentous Complex, and Neurologic Status.

Vaccaro, Oner, et al.Spine (Phila Pa 1976)2005866 citationsConsensus statement

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FLOW Investigators, Guyatt, et al.N Engl J Med2015347 citationsRCT

Curve Progression in Idiopathic Scoliosis.

Weinstein, PonsetiJ Bone Joint Surg Am1983641 citationsRetrospective cohort

Traumatic Glenohumeral Bone Defects and Their Relationship to Failure of Arthroscopic Bankart Repairs: Significance of the Inverted-Pear Glenoid and the Humeral Engaging Hill-Sachs Lesion.

Burkhart, De BeerArthroscopy20001,884 citationsCase series

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Baumgaertner, Keggi, et al.J Bone Joint Surg Am19951,441 citationsRetrospective cohort

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Natural History of Asymptomatic Rotator Cuff Tears: A Longitudinal Analysis of Asymptomatic Tears Detected Sonographically.

Yamaguchi, Middleton, et al.J Shoulder Elbow Surg2001498 citationsRetrospective cohort

The Rotator Crescent and Rotator Cable: An Anatomic Description of the Shoulder's "Suspension Bridge".

Burkhart, Jolson, et al.Arthroscopy1993469 citationsAnatomic study

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O'Driscoll, Morrey, et al.J Bone Joint Surg Am1991997 citationsCase series

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Arnoczky, WarrenAm J Sports Med19821,227 citationsAnatomic study

Metastatic Disease in Long Bones. A Proposed Scoring System for Diagnosing Impending Pathologic Fractures.

MirelsClin Orthop Relat Res19891,222 citationsRetrospective cohort

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A System of Staging Musculoskeletal Neoplasms.

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Elbow Instability.

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Gerber, Vinh, et al.J Bone Joint Surg Am1990441 citationsAnatomic study

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Judet, Letournel, et al.J Bone Joint Surg Am1964980 citationsCase series

Inferior Capsular Shift for Involuntary Inferior and Multidirectional Instability of the Shoulder. A Preliminary Report.

Neer, FosterJ Bone Joint Surg Am1980934 citationsCase series

The Impact of Positive Sagittal Balance in Adult Spinal Deformity.

Glassman, Schwab, et al.Spine (Phila Pa 1976)20051,878 citationsRetrospective cohort

An Analysis of Outcomes of Reconstruction or Amputation after Leg-Threatening Injuries.

Bosse, Castillo, et al.N Engl J Med2002901 citationsProspective cohort

Normal and Abnormal Motion of the Shoulder.

Poppen, WalkerJ Bone Joint Surg Am1976886 citationsCase-control study

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Harms, MelcherSpine (Phila Pa 1976)20011,528 citationsCase series

A Randomized Trial of Vertebroplasty for Osteoporotic Spinal Fractures.

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Hoffman, Zucker, et al.N Engl J Med20001,302 citationsProspective cohort

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A Classification for Congenital Limb Malformations.

SwansonJ Hand Surg Am1976429 citationsReview article

Treatment of Grade IV Fracture-Dislocation of the Hip.

PipkinJ Bone Joint Surg Am1957445 citationsCase series

Compression-Plate Fixation in Acute Diaphyseal Fractures of the Radius and Ulna

Anderson, Park, et al.J Bone Joint Surg Am1975416 citationsCase series

Legg-Calve-Perthes Disease. Part II: Prospective Multicenter Study of the Effect of Treatment on Outcome.

Herring, Browne, et al.J Bone Joint Surg Am2004143 citationsProspective cohort

The Role of the Scapula in Athletic Shoulder Function.

KiblerAm J Sports Med19981,240 citationsReview article

The SLAC Wrist: Scapholunate Advanced Collapse Pattern of Degenerative Arthritis.

Watson, BalletJ Hand Surg Am19841,138 citationsRetrospective cohort

Classification and an Algorithmic Approach to the Reconstruction of Femoral Deficiency in Revision Total Hip Arthroplasty.

Valle, PaproskyJ Bone Joint Surg Am2003199 citationsRetrospective cohort

The Tibial Plateau Fracture. The Toronto Experience 1968--1975.

Schatzker, Bruce, et al.Clin Orthop Relat Res19791,029 citationsRetrospective cohort

Surgical Dislocation of the Adult Hip a Technique with Full Access to the Femoral Head and Acetabulum without the Risk of Avascular Necrosis.

Ganz, Berlemann, et al.J Bone Joint Surg Br20011,367 citationsCase series

Predictors of Humeral Head Ischemia after Intracapsular Fracture of the Proximal Humerus.

Hertel, Leunig, et al.J Shoulder Elbow Surg2004837 citationsProspective cohort

Early versus Delayed Stabilization of Femoral Fractures. A Prospective Randomized Study.

Bone, Scheinberg, et al.J Bone Joint Surg Am1989795 citationsRCT

Acetabulum Fractures: Classification and Management.

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Fisher, Fourney, et al.Spine (Phila Pa 1976)20101,224 citationsConsensus statement

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|

Recurrent or Habitual Dislocation of the Shoulder-Joint

Bankart·Br Med J·1923·700 citations·Case series

Free Full Text·DOI·PubMed

|

Bankart challenges the prevailing view that recurrent shoulder dislocation stems from a lax capsule or weak muscles. Based on four operative cases, he identifies detachment of the capsule and labrum from the anterior glenoid rim as the essential lesion. He describes a surgical exposure and repair that reattaches the tissue to the rim.

Key Findings

The essential lesion is detachment of the capsule and labrum from the anterior glenoid rim, later known as the Bankart lesion. This reframed recurrent instability as a discrete structural defect, not diffuse laxity.
Detachment spans the entire anterior half of the glenoid rim, and the torn tissue has no tendency to reunite with fibrocartilage. The defect is therefore permanent, allowing the humeral head to slip forward on slight provocation.
The recurrent injury is caused by a direct backward drive on the shoulder or elbow, not the abduction-leverage fall that produces a first-time dislocation. This distinction explains why athletes and epileptics who fall with arms adducted are affected.
Bony fractures of the anterior glenoid or greater tuberosity may coexist but are incidental, not essential, to the pathology.
Repair reattaches the capsulolabral tissue to a freshened glenoid rim with interrupted silkworm gut sutures, after taking down the coracoid and subscapularis for exposure.
Of 4 operated cases, 3 regained full motion with zero recurrences. The single poor result was an epileptic who neglected postoperative rehabilitation.

Board PearlRecurrent anterior shoulder dislocation is caused by capsulolabral detachment from the anterior glenoid rim, not capsular laxity, and is repaired by reattaching it.

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