Luxation of the shoulder is one of the most frequent cases of malfunction in this area. Quite often, such injuries are experienced by athletes, although the loss of the head of the arm bone from the cavity can happen with any unsuccessful fall. A luxation of the shoulder joint is determined during the initial test by a traumatologist. To accurately visualize the luxation, the patient is prescribed an x-ray.
Bankart tears are anterior, lower and posterior, depending on where the head of the humerus has moved. Bankart repair is a widely-spread surgery in this case.
Most often, Bankart tears occur due to trauma. However, in addition to the Bankart tear itself, other causes can contribute to the malfunctions such as generalized hypermobility of the joints and multiple elongation of the shoulder.
At the first Bankart tear, in most cases there is pain, which is mostly caused by rupture of fleshy tissues. With repeated luxations, the pain is much less or it may not be at all. This is because the tissues that stabilize the shoulder have been traumatized in previous luxations. The surgery such as Bankart repair may be the only solution for this malfunction
Since the head of the arm bone is not in the joint, movement is very limited. Swinging movements are more often possible, the shoulder seems to “spring” rather than move.
Treatment Options for Bankart Repair
First of all, it should be said that the sooner you see a doctor to correct the Bankart tear, the easier it is to correct the shoulder without having to undergo Bankart repair. The first luxations are harder to correct than the repeated ones, even by the method of Bankart. After the diagnosis, the doctor makes an attempt at closed (that does not require a surgery) repositioning of luxation. For this, special techniques are used, and Bankart repair is one of them. Before the shoulder relaxation is reduced, anesthesia is performed, as a rule, a solution of novocaine is injected into the joint.
Bankart Repair Surgery
There are many options for a surgery to make the shoulder joint stable, but Bankart repair is currently the gold standard treatment for common shoulder instability. Now Bankart repair is performed arthroscopically, i.e. without the traditional cut. During the Bankart surgery, through one puncture 1-2 centimeters long, a video camera is input into the shoulder joint and all injuries are examined from the inside. Through 1-2 other small punctures, special instruments are inserted into the shoulder joint, which create a new articular lip to replace the old one, which, as a rule, is completely constrained by previous shoulder luxations and is simply absent.
To perform such a surgery, so-called anchor clamps are required. These are special devices that have a special lock at one end, to which very strong threads are attached. By the type of material from which the anchor itself is made, they are of two types – absorbable and non-absorbable. Non-absorbable retainers – metal (usually from titanium alloys), are made in the form of a screw that is inserted into the bone canal and remains there forever. In general, modern alloys are very safe and prolonged use of the retainer does not cause any problems after Bankart treatment. The advantage of non-absorbable (metal) retainers is that they are more durable. Another version of the fixator is absorbable. It is made from a special material (usually polylactic acid), which is absorbed and replaced by bone in a few months after the surgery. Such anchors in the shoulder are not visible on X-ray. Absorbable anchor clamps are made both in the form of a screw and in the form of a special wedge, which, turning, is fixed in the bone.