Bankart Lesion and Treatment
The first occurrence of shoulder dislocations usually occurs after major trauma. If people do not receive adequate and necessary treatment after these dislocations, it can be surprisingly easy for them to experience second and third dislocations. Especially if the first shoulder dislocation occurred under the age of 20, the probability of re-dislocation is over 80%. These recurrent shoulder dislocations are referred to as Bankart lesion.
.What are the Types of Recurrent Dislocations?
Traumatic Dislocations: These dislocation type; It occurs for the first time as a result of a significant trauma such as a fall, impact or traffic accident, and is seen with a tear of the shoulder support cartilage called the labrum.
Atraumatic Dislocations: These dislocations occur due to stress as a result of daily movements and are usually seen in both shoulders. For the treatment of this type of dislocations, physical therapy is first applied. The shoulder of patients suffering from atraumatic shoulder dislocation is very easily dislocated and re-entered. However, in cases where physical therapy is not effective, surgical methods are used.
Voluntary Dislocations: In this type of dislocations, patients can voluntarily remove and replace their own shoulders. However, patients should avoid this and seek treatment. In these dislocations, physical therapy can be applied, as well as surgical methods.
HOW IS THE DIAGNOSIS?
Recurrent dislocations cause deterioration and calcification in the shoulder joint, while the muscle and muscle around the shoulder are damaged. It can cause permanent damage to tendons. Additionally, shoulder dislocations that occur at unexpected times cause additional injuries. The diagnosis of Bankart lesion is made with the help of physical examination, dislocation history, and imaging methods such as MRI.
DISEASE HISTORY
In traumatic dislocations, falls, impact and There is a history of serious trauma such as a traffic accident, and labrum tears are also observed in dislocations that occur for this reason. He definitely needs to go to surgery. In atraumatic dislocations, there is no history of trauma; the shoulder is dislocated due to sudden or repetitive forceful movements. Significant improvement can be achieved with physical therapy in this type of dislocations. A very small percentage of patients do not respond to treatment and go to surgery. In surgical intervention, physicians use the atroscopic method to stitch the torn part of the labrum to special screws that they attach to the bone and stabilize that point again. In some cases, the joint capsule is also narrowed.
What is the Treatment?
If the physician has not decided on surgery, the patient must receive physiotherapy. Shoulder dislocations are prevented by strengthening the muscles that hold the arm inside. If the patient has undergone surgery due to this condition, they are taken to a rehabilitation program with physiotherapists after the surgery. The arm remains in a sling for 4 weeks, and shoulder shaking exercises are given during the period the arm is in a sling. Between weeks 4-6, passive movements as well as some active movements are allowed. Between 6-10 weeks, patients can perform many daily movements, and physical therapy aims to increase the patients' mobility. All movements except throwing movements are allowed in 10-12 weeks, and all movements are allowed between 12-16 weeks. After 16 weeks, you can return to some sports, and after 6 months, you can return to sports that require excessive arm movements, such as basketball.
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