Arthroscopic observation of capsulolabral reduction after shoulder dislocation

Abstract

The standard treatment for most first-time anterior shoulder dislocations is reduction and immobilization. This places the arm in a position of adduction and internal rotation. We question whether this position assists or hinders reduction of a displaced capsulolabral injury (Bankart lesion). This study examined the pathology present after traumatic first-time anterior shoulder dislocations and looked at the reduction of the Bankart lesion in internal and external rotation. A series of 25 patients with Bankart lesions were identified who underwent arthroscopy at a mean of 10.5 days after first-time anterior shoulder dislocations. We found that there is wide variation in pathology after anterior dislocation. In 23 of 25 patients in whom the capsulolabral complex was detached (Bankart lesion), we found that external rotation of the arm improved the reduction of the labrum (92%). We conclude that in patients with a displaced Bankart lesion, the standard treatment of immobilization in internal rotation may hinder anatomic healing of this injury.