Hawkins – Bankart 2

Hawkins-Bankart2
complete the connection. You need to start the hole about 4 mm into the glenoid articular surface. Then pass the three sutures. Take out the forked retractor and pull the capsule laterally using a Kocher. Now the forked retractor goes onto the outside of the capsule and retracts away subscap. You need to pull the capsule laterally before pushing down on this retractor, or else you will trap the capsule medially and after repairing it down to the glenoid you will not have enough to suture back to the humerus. The medial stitch end is taken through first, and make sure this “pulls” the capsule as far lateral as possible. Then the Mayo needle is used on the lateral stitch end, placing this through the capsule in such a way as to pull down a cuff of capsule down onto the articular surface of the edge of the glenoid – thus re-creating a soft tissue labrum. Repeat this for all three sutures.

Once the Bankart repair is complete, then you need to consider pulling the inferior capsule up. Again, use pop-off sutures and repair the capsule back onto its insertion. The subscap is then repaired over top of this.