Bony Bankart lesions: epidemiology of 790 cases from the Swedish Fracture Register

Abstract

Background: A bony Bankart lesion is a common type of fracture associated with anterior shoulder dislocation. This type of fracture could directly affect the stability of the shoulder by reducing the glenoid joint-contact area. The aim of this study was to report and describe epidemiological data relating to bony Bankart lesions in Sweden using the Swedish Fracture Register. The purpose is to evaluate age and sex distribution in the population with BB lesions, its impact on treatment strategy and to analyse patient-reported outcomes. Methods: An epidemiological descriptive study based on data from the national Swedish Fracture Register. The inclusion criteria were all patients with a unilateral bony Bankart lesion registered between April 2012 and April 2019. The patients’ specific data (age, sex, type and time of injury, treatment option and patient-reported outcomes) were extracted from the Swedish Fracture Register database. Results: A total of 790 unilateral bony Bankart fractures were identified. The majority of the patients were male (58.7%). The mean age ± SD for all patients at the time of injury was 56.3 ± 16.1 years. Females had a higher mean age, 64.3 ± 12.8, compared with males, 50.7 ± 15.7. Most of the BB lesions, 91.8% (662), were registered as a low-energy trauma. More than two-thirds of all cases, 509 patients (70.1%), were treated non-surgically, 217 patients (29.9%) were treated surgically, while, in 17 patients (7.8% of all surgically treated patients), the treatment was changed from non-surgical to surgical. Surgical treatment was chosen for 34% (146) of males and for 23% (71) of females. Patient quality of life decreased slightly in both surgically and non-surgically treated groups one year after BB injury. Conclusion: This national register-based study provides detailed information on the epidemiology, choice of treatment and patient-reported outcomes in a large cohort of bony Bankart lesions. Most BB lesions affected males between 40 and 75 years after low-energy falls and were treated non-surgically.