Bankart lesion

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Bankart lesions are a common complication of anterior shoulder dislocation and are frequently seen in association with a Hill-Sachs lesion.

Pathology

They result from detachment of the anterior inferior labrum from the underlying glenoid. It may be labral only ("soft Bankart"), or involve the bony glenoid margin (impaction fracture) and this is called a "bony Bankart". Additionally, labral tears may also be present.

Variants

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

Radiographic features

Conventional radiography

bony Bankart lesion may be seen as a fracture of the anteroinferior aspect of the glenoid ⁴

CT

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

MRI

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.

Differential diagnosis

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.

-<p><strong>Bankart lesions</strong> are a common complication of anterior shoulder dislocation and are frequently seen in association with a <a href="/articles/hill-sachs-lesion">Hill-Sachs lesion</a>. </p><h4>Pathology</h4><p>They result from detachment of the anterior inferior <a href="/articles/glenoid-labrum">labrum</a> from the underlying <a href="/articles/glenoid">glenoid</a>. It may be <a href="/articles/glenoid-labrum">labral</a> only ("soft Bankart"), or involve the bony margin (impaction fracture) and this is called a "bony Bankart". Additionally, <a href="/articles/glenoid-labral-tear">labral tears</a> may also be present.</p><h5>Variants</h5><ul>
+<p><strong>Bankart lesions</strong> are a common complication of anterior shoulder dislocation and are frequently seen in association with a <a href="/articles/hill-sachs-lesion">Hill-Sachs lesion</a>. </p><h4>Pathology</h4><p>They result from detachment of the anterior inferior <a href="/articles/glenoid-labrum">labrum</a> from the underlying <a href="/articles/glenoid">glenoid</a>. It may be <a href="/articles/glenoid-labrum">labral</a> only ("soft Bankart"), or involve the bony glenoid margin (impaction fracture) and this is called a "bony Bankart". Additionally, <a href="/articles/glenoid-labral-tear">labral tears</a> may also be present.</p><h5>Variants</h5><ul>
-<a href="/articles/anterior-labroligamentous-periosteal-sleeve-avulsion-lesion">anterior labroligamentous periosteal sleeve avulsion</a>: mobilised labrum remains attached to the glenoid periosteum</li>
+<a href="/articles/anterior-labroligamentous-periosteal-sleeve-avulsion-lesion">anterior labroligamentous periosteal sleeve avulsion</a> (ALPSA): mobilised labrum remains attached to the glenoid periosteum</li>
-<li>the <a title="Double axillary pouch sign" href="/articles/double-axillary-pouch-sign">double axillary pouch sign</a> on coronal MR arthrogram is a specific sign for an anteroinferior labral tear</li>
+<li>the <a href="/articles/double-axillary-pouch-sign">double axillary pouch sign</a> on coronal MR arthrogram is a specific sign for an anteroinferior labral tear</li>

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