The Amateur Cliff Jumper - Page #4
 

Working Diagnosis:
Bony Bankart lesion with Hill-Sachs deformity

Treatment:
Patient underwent an open reduction with internal fixation of left glenoid/scapular fracture with repair of anterior labrum Case Photo #5 . He then completed three months of physical therapy followed by home exercise program.

Author's Comments:
A high-energy traumatic event represents a higher risk for a Bankart or Hill-Sachs lesion and requires a thorough clinical analysis. Clinical examination provides findings consistent with a dislocated shoulder and exemplifies the use of functional tests such as the sulcus sign, load and shift test, and the apprehension test. This case illustrates the history and exam findings that commonly occur with Bankart lesions and the advanced imaging that is often necessary to confirm the diagnosis. Surgical repair is the treatment of choice, particularly for active individuals, to reduce the risk of recurrent shoulder dislocations and joint injury, and represent a significantly higher success rate. This case also highlights the importance of early recognition of anterior shoulder dislocations in reducing risk of long-term complications such as axillary nerve injury from prolonged traction of the humeral head on neural structures.

Editor's Comments:
Articles for suggested review: "Ee GW, Mohamed S, Tan AH. Long term results of arthroscopic Bankart repair for traumatic anterior shoulder instability. J Orthop Surg Res. 2011;6:28. Published 2011 Jun 14," "Kraeutler MJ, Aberle NS, Brown CC, Ptasinski JJ, McCarty EC. Clinical Outcomes and Return to Sport After Arthroscopic Anterior, Posterior, and Combined Shoulder Stabilization. Orthop J Sports Med. 2018;6(4):2325967118763754. Published 2018 Apr 3."

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