Bankart lesions are a common complication of anterior shoulder dislocation and are frequently seen in association with a Hill-Sachs lesion.
They result from detachment of the anterior inferior labrum from the underlying glenoid as a direct result of the anteriorly dislocated humeral head compressing against the labrum. It may be labral only ("soft Bankart"), or involve the bony glenoid margin (impaction fracture) and this is called a "bony Bankart". Soft Bankart lesions are more common than bony Bankart lesions 5. Additionally, labral tears may also be present.
The same mechanism of compression can result in a Hill-Sachs lesion. Bankart and Hill-Saches lesions are 11x more likely to occur together than be isolated injuries 5.
- Perthes lesion of the shoulder: tear of the glenoid labrum, but with an intact scapular periosteum 2
- anterior labroligamentous periosteal sleeve avulsion (ALPSA): mobilised labrum remains attached to the glenoid periosteum
- bony Bankart lesion may be seen as a fracture of the anteroinferior aspect of the glenoid 4
- on non-contrast CT, a fracture may be seen at the anteroinferior aspect of the glenoid (i.e. bony Bankart)
- CT arthrography may demonstrate labral avulsion (i.e. soft Bankart) 4
- displaced anterior glenoid labrum with bone
- linear high T2/PD intensity coursing through the normally low signal antero-inferior labrum
- abnormally small or absent anterior labrum 3
- the double axillary pouch sign on coronal MR arthrogram is a specific sign for an anteroinferior labral tear
Treatment and prognosis
Bankart lesions do heal, and therefore early surgical intervention (if any) is not required. In Bankart repairs, the labral fragment is sutured back to the glenoid rim using suture anchors.
A number of lesions are closely related have similar appearances, see anterior glenohumeral injury for discussion of the differences.
History and etymology
It is named after Arthur Sydney Blundell Bankart, British orthopedic surgeon.
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- 5. Horst K, Von Harten R, Weber C et-al. Assessment of coincidence and defect sizes in Bankart and Hill-Sachs lesions after anterior shoulder dislocation: a radiological study. Br J Radiol. 2004;87 (915): 20130673. doi:10.1259/bjr.20130673 - Pubmed citation