A Bankart lesion of the shoulder is a tear of the labrum that causes instability and recurrent dislocations of the shoulder joint. This type of injury often occurs when the shoulder pops out of joint, thereby tearing the labrum. This is quite common in younger patients.

Cause

A Bankart tear is a specific injury to a part of the shoulder joint called the labrum. The shoulder joint is a ball and socket joint, similar to the hip; however, the socket of the shoulder joint is extremely shallow, and thus inherently unstable.

Symptoms

When the labrum of the shoulder joint is torn, the stability of the shoulder joint may be compromised. A specific type of labral tear is called a Bankart tear. A Bankart tear occurs when an individual sustains a shoulder dislocation. As the shoulder pops out of joint, it often tears the labrum, especially in younger patients. The tear is to part of the labrum called the inferior glenohumeral ligament. When the inferior glenohumeral ligament is torn, this is called a Bankart tear.

Typical symptoms of a Bankart tear include:

• a sense of instability
• repeat dislocations
• catching sensations
• aching of the shoulder

Often patients will complain that they cannot trust their shoulder, fearing it may dislocate again.

Diagnosis

Most young patients (under the age of 30) who sustain a shoulder dislocation will sustain a Bankart tear; therefore, there is a high suspicion of this injury whenever a young patient dislocates their shoulder. On examination, patients will often have a sense their shoulder is about to dislocate if their arm is placed behind their head.

X-rays are sometimes normal, but they may show an injury to the bone called a Hill-Sachs lesion. This is a divot of bone that was injured when the shoulder dislocation occurred. An MRI may also be obtained in patients who have dislocated their shoulder. Bankart tears do not always show up well on MRI scans. When a MRI is performed with an injection of contrast solution, a Bankart tear is much more likely to be seen.