Abstract：
BACKGROUND: The optimal treatment approach for Bony Bankart remains a subject of considerable debate among shoulder surgeons. Existing literature highlights low recurrence rates and high patient satisfaction with nonoperative treatment, particularly in the middle-aged population. This study aimed to evaluate the recurrence rate of dislocation, as well as the clinical and functional outcomes in middle-aged individuals treated nonoperatively following an acute bony Bankart fracture. Additionally, the impact of glenoid rim size and fragmentation on the treatment outcome was investigated.
METHODS: A prospective analysis was conducted on 20 patients aged over 50 with nonoperatively treated bony Bankart fractures, ensuring a minimum follow-up of 24 months. The study population was categorized based on fragment size (small and medium) according to Kim classification and glenoid rim fragmentation (type 1b and 1c) according to Scheibel classification. Data including UCLA score, Rowe score, recurrence rate, clinical instability, and range of motion (ROM) were collected and analyzed.
RESULTS: The average UCLA and Rowe scores were 32.15 ± 2.85 and 93.85 ± 2.19, respectively, with no instances of dislocation recurrence. The affected shoulder exhibited no significant reductions in ROM compared to the contralateral side, except for a loss of external rotation (ER) (13.08° ± 7.51; p = 0.005). No differences were observed based on fragment size, although patients with multifragmented glenoid rims showed a greater loss of ER compared to those with a solitary fragment, albeit not reaching statistical significance.
CONCLUSIONS: Nonoperative treatment appears to be a viable and effective option for middle-aged individuals with bony Bankart fractures, resulting in favorable functional outcomes and a low risk of recurrence. Additionally, a notable loss of external rotation was observed in fractures with glenoid rim fragmentation.
METHODS: IV.
METHODS: A prospective analysis was conducted on 20 patients aged over 50 with nonoperatively treated bony Bankart fractures, ensuring a minimum follow-up of 24 months. The study population was categorized based on fragment size (small and medium) according to Kim classification and glenoid rim fragmentation (type 1b and 1c) according to Scheibel classification. Data including UCLA score, Rowe score, recurrence rate, clinical instability, and range of motion (ROM) were collected and analyzed.
RESULTS: The average UCLA and Rowe scores were 32.15 ± 2.85 and 93.85 ± 2.19, respectively, with no instances of dislocation recurrence. The affected shoulder exhibited no significant reductions in ROM compared to the contralateral side, except for a loss of external rotation (ER) (13.08° ± 7.51; p = 0.005). No differences were observed based on fragment size, although patients with multifragmented glenoid rims showed a greater loss of ER compared to those with a solitary fragment, albeit not reaching statistical significance.
CONCLUSIONS: Nonoperative treatment appears to be a viable and effective option for middle-aged individuals with bony Bankart fractures, resulting in favorable functional outcomes and a low risk of recurrence. Additionally, a notable loss of external rotation was observed in fractures with glenoid rim fragmentation.
METHODS: IV.
摘要：
背景：BonyBankart的最佳治疗方法在肩关节外科医师中仍存在相当大的争论。现有文献强调低复发率和高患者对非手术治疗的满意度，尤其是中年人。本研究旨在评估脱位的复发率，以及急性骨性Bankart骨折后非手术治疗的中年人的临床和功能结局。此外,研究了关节盂边缘大小和碎片对治疗结果的影响.
方法：对20例50岁以上非手术治疗的Bankart骨性骨折患者进行了前瞻性分析，确保至少24个月的随访。根据Kim分类的碎片大小（小和中）和根据Scheibel分类的关节盂边缘碎片（1b和1c型）对研究人群进行分类。包括加州大学洛杉矶分校分数在内的数据，Rowe得分,复发率,临床不稳定，和运动范围（ROM）进行了收集和分析。
结果：UCLA和Rowe的平均得分为32.15±2.85和93.85±2.19，没有脱位复发的实例。与对侧相比，受影响的肩部的ROM没有显着减少，除了外部旋转损失（ER）（13.08°±7.51；p=0.005）。根据片段大小没有观察到差异，尽管与具有孤立性片段的患者相比，关节盂边缘多碎片的患者表现出更大的ER损失，虽然没有达到统计意义。
结论：非手术治疗似乎是中年人骨性Bankart骨折的可行和有效的选择，导致良好的功能结局和低复发风险。此外,在关节盂边缘碎裂的骨折中观察到明显的外旋转丧失。
方法：IV.
方法：对20例50岁以上非手术治疗的Bankart骨性骨折患者进行了前瞻性分析，确保至少24个月的随访。根据Kim分类的碎片大小（小和中）和根据Scheibel分类的关节盂边缘碎片（1b和1c型）对研究人群进行分类。包括加州大学洛杉矶分校分数在内的数据，Rowe得分,复发率,临床不稳定，和运动范围（ROM）进行了收集和分析。
结果：UCLA和Rowe的平均得分为32.15±2.85和93.85±2.19，没有脱位复发的实例。与对侧相比，受影响的肩部的ROM没有显着减少，除了外部旋转损失（ER）（13.08°±7.51；p=0.005）。根据片段大小没有观察到差异，尽管与具有孤立性片段的患者相比，关节盂边缘多碎片的患者表现出更大的ER损失，虽然没有达到统计意义。
结论：非手术治疗似乎是中年人骨性Bankart骨折的可行和有效的选择，导致良好的功能结局和低复发风险。此外,在关节盂边缘碎裂的骨折中观察到明显的外旋转丧失。
方法：IV.
