What is a Bankart Lesion?
A
Bankart lesion is a specific type of shoulder labral tear. It is
extremely common with shoulder dislocations, and often contributes to
shoulder instability.
You
may be able to be treated conservatively, but more often it requires
surgical intervention for a full recovery.
Read on
to find out more about this type of labral tear, causes, and treatment
options.
Causes
By far the most common cause of a Bankart lesion
is an
anterior shoulder dislocation.
Most
shoulder dislocations occur when the humerus moves too far anteriorly
(forward) and inferiorly (down). The humeral head displaces out of the
shoulder socket, causing tearing of the joint capsule and the labrum.
The
most common way to dislocate your shoulder is forceful external
rotation when your arm is raised at shoulder level or higher. Excessive
force applied in this position places a great deal of stress on your
shoulder capsule and labrum, often resulting in tearing of the tissues.
Over
95% of all shoulder dislocations have an accompanying Bankart tear.
Signs
and Symptoms
The
most common symptom of a bankart tear is pain. Following a shoulder
dislocation, moderate to severe pain is felt, especially within the
first several days after injury.
Popping or feelings
of
instability are another common problem associated with Bankart tears.
Your shoulder labrum acts as a bumper for the shoulder socket, helping
to keep your humerus in place. If this bumper is displaced, it allows
your humerus to move too far forward and down within the joint, causing
feelings of instability.
The torn portions of the
labrum may also become caught within the joint, causing popping or
feelings of the shoulder locking up.
Weakness of the
muscles and loss of range of motion are also common symptoms associated
with bankart lesions.
Initial Treatment
Initial
treatment for a shoulder dislocation is centered around the
R.I.C.E. principles,
as well as immobilization of the shoulder to allow the tissues to heal.
Labral tears are considered a secondary problem with shoulder
dislocations.
If
you have a dislocation, you will most likely have to have the shoulder
reduced or put back into place by a physician. You will be given a
sling to wear, and may be referred for an MRI.
MRI
of the
shoulder will often show damage to the joint capsule, but it may not
pick up on a labral tear. That is why many surgeons order an MRI
Arthrogram.
This procedure involves injection of a
dye into
the shoulder joint and then an MRI to see if any of the dye escapes
from the shoulder capsule.
If you have a labral
tear, the area
that is torn will allow the dye to move out of the shoulder joint.
Although MRI Arthrograms are much better to find labral tears than a
regularr MRI, there is still a good chance that you may have a negative
MRI but still have a tear.
Rehabilitation
After
a shoulder dislocation,
conservative shoulder rehabilitation
that focuses on restoring your range of motion, strength, and shoulder
function is a good idea. The goal is to try to avoid surgery if
possible.
Depending on the severity of your injury,
you may be
able to avoid surgery with proper rest and rehab. However, if you have
a Bankart lesion or other labral tear, you may have instability and
require
labral repair surgery.
Make
sure that you follow your physicians instructions after your injury and
go through rehabilitation to restore your shoulder back to normal.
Summary
A
Bankart lesion is a type of labral tear that occurs in the inferior and
anterior portion of the glenoid labrum. It is very common with shoulder
dislocations. An MRI Arthrogram is the best way to determine if you
have a bankart tear. Rest and rehabilitation are the keys to recovery,
however many times this injury requires surgical intervention to return
your shoulder to normal.
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