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Bankart Lesion

Description

Antero-inferior detachment of the glenoid labrum, commonly (85-97%) associated with first-time traumatic anterior shoulder dislocations.

Bankart lesion is often associated with the Hill-Sachs lesion due to their common mechanism of injury. Bankart Lesion may involve the labrum only (“soft Bankart“), or involve the glenoid bone itself (“bony Bankart”).

  • The soft tissue Bankart lesion involves injury to the anterior or anteroinferior glenoid labrum, the fibrocartilagenous structure that surrounds and deepens the bony glenoid.
  • An osseous or bony Bankart lesion (a, b) is a fracture of the anterior-inferior glenoid cortical rim on which the labrum rests
  • Like the Hill-Sachs lesion, a Bankart lesion may result in anterior shoulder joint instability and recurrent dislocations.
Bankart bony lesion XR
Bankart bony lesion on XR
Bony-Bankhart-lesion
Bony Bankart lesion: (a) irregularity of inferior glenoid rim (arrow); (b) double contour of inferior margin of glenoid (arrowheads).

History of the Bankart Lesion

1890Broca and Hartmann gave a good description of the lesion, but their work was neglected. [5, serie IV, 312-336. June 1890]

1906Perthes recognised that the inferior glenoid fracture with detachment of the labrum caused instability of the shoulder and emphasized reattachment of the labrum to stabilize the joint.

Die operative Behandlung der rezidivierenden Schultergelenksluxation ist noch kein abgeschlossenes Kapitel der Chirurgie…Bedeutungsvoller scheint mir vielmehr in einer gewissen Gruppe von Fällen der Abriß der am Tuberculum majus inserierenden Muskeln, und in einer anderen der Abriß des Labrum glenoidale am inneren Pfannenrande. Die Rücksicht auf diese pathologischen Veränderungen führte mich dazu, in zwei Fällen die verloren gegangene Insertion der Muskeln am Tuberculum majus wiederherzustellen, in einem weiteren Fall die am inneren Pfannenrand abgesprengte Gelenklippe wieder zu befestigen, während in einem vierten Falle nur die Verkleinerung und Verstärkung der erweiterten und erschlafften Kapsel ausgeführt wurde.

Perthes, 1906;85: 199-227

The operative treatment of recurrent shoulder subluxations is still no concluded chapter in surgery…Of greater significance it would seem to me, is in a certain group of cases the tearing of the muscles inserting on the major tubercle, and in another group, the tearing of the glenoid labrum on the inner glenoid fossa. The consideration of these pathological changes led me to reconstruct the lost insertion point of the muscles on the major tubercle in two cases, in a further case to reattach the labrum to the glenoid, whilst in a fourth only the reduction and reinforcement of the enlarged and loosened capsule was performed

Perthes, 1906; 85: 199-227

1923 – It is largely due to Bankart’s emphasis that the defect has become widely known [Br Med J 1923; 2: 1132-3].


Associated Persons

Alternative names
  • Bankart fracture; Bankart lesion

References

Original articles

Review articles


BA MA (Oxon) MBChB (Edin) FACEM FFSEM. Emergency physician, Sir Charles Gairdner Hospital.  Passion for rugby; medical history; medical education; and asynchronous learning #FOAMed evangelist. Co-founder and CTO of Life in the Fast lane | Eponyms | Books | Twitter |

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