Paper #37 Motion fraction analysis for evaluation of functional recovery after Bankart repair of shoulder instability

To develop an objective guideline for muscle coordination during rehabilitation after shoulder instability repair, we serially compared glenohumeral to scapulothoracic motion fraction after arthroscopic and open Bankart repair. We reviewed 24 patients of anterior shoulder instability treated from May, 1996 to June, 1999. Arthroscopic Bankart repair was in 16 cases and open Bankart repair was in 8 cases. Average age was 26 years old and involved in dominant arm in 15 cases. Patients suffered instability for 3.1 years before operation and mean follow-up was 2 year 9 months (1 year 9 months - 4 year 10 months). Glenohumeral to scapulothoracic motion fraction recovery was compared to functional recovery of Rowe’s Bankart Grading scale. At six months follow up, motion fraction was recovered in full elevation but delayed recovery in 90 degrees elevation in both arthroscopy and open group. Average 2.3 years follow up, motion fraction was recovered in both 90 degree and full elevation in arthroscopy group. Average 2.8 years follow up, still delayed recovery in 90 degrees elevation in open group. In arthroscopic surgery, 2 cases (13%) were redislocated, and 4 cases (25%) showed mild instability. In open case, 1 case (13%) showed mild instability. According to functional result by Rowe grading scale, satisfactory results were 12 cases (76%) in arthroscopic repair and 7 cases (88%) in open cases. Motion fraction could be the guideline for rehabilitation program to avoid reinjury and promote muscle coordination exercise in both arthroscopic and open Bankart repair of shoulder instability.