Bony Bankart Lesions Exceeding 20% of Glenoid Width Are Common and Show Gender-Based Anatomical Differences: A Radiological study of 239 Patients.

IF 3.3 Q1 ORTHOPEDICS
Vladislavs Gordins, Mikael Sansone, Louise Karlsson, Nicklas Olsson, Neel Desai
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引用次数: 0

Abstract

Introduction/objectives: Bony Bankart lesions are anterior glenoid rim fractures associated with anterior shoulder dislocation and can increase the risk of recurrent instability, particularly in cases of fragment resorption or malpositioned healing . Despite their clinical significance, few large-scale radiological studies have detailed the fragment characteristics, displacement patterns, and associated bipolar lesions. The objective of this study was to describe fragment morphology, displacement, and related shoulder parameters using CT imaging.

Methods: This retrospective cohort study included 239 patients with isolated bony Bankart injuries identified via the Swedish Fracture Register between 2012 and 2019. All patients underwent CT imaging. Standardized linear measurement techniques were used to assess fragment size, displacement (inferior migration, diastasis, and step-off), Hill-Sachs lesion characteristics, glenoid version, and glenohumeral subluxation index.

Results: The mean bony Bankart fragment size was 6.5 mm, representing 21.8% of the glenoid width. While absolute fragment size was similar between sexes, it accounted for a significantly larger portion of the glenoid surface in females (p=0.008). Fragment displacement parameters showed no sex-based differences. Hill-Sachs lesions were present in 61% of patients and were significantly larger in males (p=0.007), though relative to humeral head diameter, differences were not significant. A consistent ratio of glenoid-to-humeral head diameter (∼66-67%) was observed across sexes.

Conclusion: Bony Bankart lesions frequently involve more than 20% of the anterior glenoid, particularly in female patients due to anatomical size differences. CT-based linear measurements provide valuable data for analyzing clinically significant critical bone loss in cases of bony Bankart injuries. The consistent glenoid-to-humeral head diameter ratio may aid surgical planning in shoulder reconstructive procedures.

Level of evidence: Level IV, diagnostic study.

超过关节盂宽度20%的骨Bankart病变是常见的,并表现出基于性别的解剖差异:239例患者的放射学研究。
介绍/目的:骨Bankart病变是肩关节前缘骨折伴肩关节前脱位,可增加复发性不稳定的风险,特别是在碎片吸收或错位愈合的情况下。尽管具有临床意义,但很少有大规模的放射学研究详细描述了碎片特征、移位模式和相关的双相病变。本研究的目的是利用CT成像描述碎片形态、位移和相关的肩部参数。方法:本回顾性队列研究纳入了2012年至2019年期间通过瑞典骨折登记发现的239例孤立性骨Bankart损伤患者。所有患者均行CT检查。标准化的线性测量技术用于评估碎片大小、位移(下移、分离和分离)、Hill-Sachs病变特征、盂骨形态和盂肱半脱位指数。结果:Bankart骨碎片平均大小为6.5 mm,占关节盂宽度的21.8%。虽然绝对碎片大小在两性之间相似,但在女性中它占关节盂表面的比例明显更大(p=0.008)。碎片位移参数没有性别差异。61%的患者存在Hill-Sachs病变,男性患者明显较大(p=0.007),尽管相对于肱骨头直径,差异不显著。肩关节头直径与肱骨头直径的比例(~ 66-67%)在两性中一致。结论:由于解剖大小的差异,骨Bankart病变经常累及20%以上的前盂关节,尤其是女性患者。基于ct的线性测量为分析Bankart骨损伤病例中临床上重要的临界骨丢失提供了有价值的数据。肩关节与肱骨头直径的一致比例有助于肩关节重建手术的手术计划。证据等级:四级,诊断性研究。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
2.90
自引率
6.20%
发文量
61
审稿时长
108 days
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