1. By Jeff Schreibman Christine Davis

2. Athlete’s Hx 21-year-old male wrestler (+) Rotatory stress test MRI findings Anterior GH dislocation w/ Type IV Bankart lesion (labral detachment w/ significant fraying or degeneration) Open Bankart Lesion Repair Abduction and Ext. Rotation S & S Step off deformity, numbness, tingling, pain, inability to move arm, bruising, swelling

4. Bankart Lesion Avulsion of the anteroinferior labrum w/ concurrent stretching of the anteroinferior capsule It can pre-dispose pt. to recurrent anterior dislocations.

5. Rehabilitation Wk 1-2 Arm is immobilized in sling for 3 weeks Avg. rehab program 15-26 wks Arm can be taken out after 1 st week ARROM, Straight-plane flexion PROM w/ elbow at side Most stressful position = Ext. Rotation w/ abduction Wk 1-2, Grade I and II joint mobes Mild distraction w/ oscillation

6. Rehab Wk 3-5 Sling is removed Joint Mobes- Grade III can begin (Scapular Plane) – Active Resistive Isotonic Ex. Int./Ext. Rotation- 20-30 degrees w/ elbow at side Abduction- 20 degrees Trigger Points may develop from being in a sling Treatment of trigger points may relieve discomfort

7. Rehab Wk 6-12 Wk 6- PROM – Shoulder Flex: WNL – Ext. Rotation: 50-60 w/ elbow at side Wk 6, joint mobes can be any grade Wk 6-10 RC exercises can increase ROM w/ low weight & high reps Wk 8-10: Full PROM present except Ext. rotation which should be 75 degrees Wk 10-12: Full PROM

8. Surgical Techniques Open Bankart Lesion Repair