An anterior-inferior labroligamentous tear, or Bankart lesion, is considered the sine que non anatomic injury for an anterior-inferior shoulder dislocation. However, up to 30% of dislocations may incur an anterior-inferior glenoid fracture, or a bony Bankart lesion. This can occur in isolation or in addition to a soft- tissue Bankart lesion. Such bony injuries may often go unrecognized because of the low sensitivity of plain radiographs. Early recognition of this pathology with subsequent fixation has shown excellent outcomes with a minimal failure rate.
Our preferred surgical technique, a modification of the method of Sugaya, encompasses a few key reproducible steps that facilitate anatomic restoration of soft-tissue tension, as well as ease of reduction and fixation, and maximizes bony healing. This technical note and accompanying video show the key steps that are necessary to yield a successful result.