Open Bankart Repair with Subscapularis Split.

Area of Science:

• Orthopedic Surgery
• Sports Medicine
• Shoulder Instability

Background:

• Anterior shoulder dislocations are common, particularly in young, active males.
• Open Bankart repair historically shows lower recurrence and reoperation rates than arthroscopic repair.
• Open repair may be preferred for recurrent instability and high-risk sports due to enhanced capsular shift.

Purpose of the Study:

• To describe an open Bankart repair technique utilizing a subscapularis split.
• To highlight the advantages of this approach over traditional tenotomy and arthroscopic methods.

Main Methods:

• The procedure involves a deltopectoral approach with a longitudinal split of the subscapularis tendon.
• A T-shaped capsulotomy is created for glenohumeral joint access.
• The labrum is repaired using knotted suture anchors, with capsular imbrication for closure.

Main Results:

• This technique provides adequate capsular shift and visualization of the Bankart lesion.
• It avoids the need for subscapularis tendon repair, reducing avulsion risk.
• The subscapularis split is associated with a lower risk of iatrogenic injury to surrounding nerves.

Conclusions:

• Open Bankart repair with a subscapularis split is a safe and effective treatment for shoulder instability.
• It offers a robust repair with potentially lower recurrence rates and reduced risk of tendon injury compared to other methods.