Functional Outcome of Modified Open Bankart Surgery in Military Personnel for Traumatic, Recurrent, Anterior Glenohumeral Dislocations
Author(s): Zafar Israil, Pankaj Poswal, Prasenjeet Singh, Ravindra Chauhan
Introduction: This study evaluates the functional outcome of modified open Bankart surgery in military personnel for traumatic, recurrent, anterior glenohumeral dislocations. With the arthroscope unavailable, there was no selection bias and 5 military orthopedic surgeons used modification of the Bankart procedure. Metallic suture anchors were used for repair of avulsed labrum along with capsular repair.
Materials and methods: This Case series was done in 30 male soldiers (30 shoulders) over a span of 4 years (2011-2014). Only recurrent (>2 dislocations), traumatic, anterior and unilateral glenohumeral dislocations were included. Hill Sach’s lesion >20 %, glenoid bone loss >10 %, atraumatic MDI, associated SLAP/Rotator cuff lesions were excluded. Pre op MRI and CT was done in all cases. All patients were followed up for a minimum of 2 years, with patients reporting regularly to the center as per existing defence medical regulations.
Results: The mean pre op Rowe score was 40.6 and mean post op Rowe score was 86.6. The mean loss of external rotation was 4.3 degrees (0 to 15 degrees) and 40 % of the study group had no loss of external rotation.76.6% of the patients (n=23) had excellent or good post op Rowe scores and were upgraded to join/continued to serve in armed forces. 23.3% of patients (n=7) had fair and poor post op Rowe scores (<75) at 2 year follow up. The failure rate was 6% with 2 patients having complications. One patient had backing out of suture anchors requiring re-surgery and the other having persistent feeling of subluxation. We conclude that modified Bankart surgery is a suitable option for military personnel.