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Incidence of bony Bankart lesions in Sweden: a study of 790 cases from the Swedish fracture register

Journal of Orthopaedic Surgery and Research volume 18, Article number: 680 (2023) Cite this article

Abstract

Background

A bony Bankart lesion directly affects the stability of the shoulder by reducing the glenoid joint-contact area. The aim of this study was to report on the epidemiological data relating to bony Bankart lesions in Sweden using the Swedish fracture register. The purpose is to evaluate age and sex distribution in the population with bony Bankart lesions, its impact on treatment strategy and further to analyse patient-reported outcomes.

Methods

This was an epidemiological descriptive study. The inclusion criteria were all patients with a unilateral bony Bankart lesion registered between April 2012 and April 2019. The patients’ specific data (age, sex, type and time of injury, treatment option and patient-reported outcomes) were extracted from the Swedish fracture register database.

Results

A total of 790 unilateral bony Bankart fractures were identified. The majority of the patients were male (58.7%). The median age for all patients at the time of injury was 57 years. Females had a higher median age of 66 years, compared with males, 51 years. Most of the bony Bankart lesions, 662 (91.8%), were registered as a low-energy trauma. More than two-thirds of all treatment registered cases, 509/734 patients (69.3%), were treated non-surgically, 225 (30.7%) were treated surgically, while, in 17 patients (7.5% of all surgically treated patients), the treatment was changed from non-surgical to surgical due to recurrent instability. Surgical treatment was chosen for 149 (35%) of the males and for 76 (25%) of the females. Patient quality of life decreased slightly in both surgically and non-surgically treated groups 1 year after bony Bankart injury.

Conclusion

This national register-based study provides detailed information on the epidemiology, choice of treatment and patient-reported outcomes in a large cohort of bony Bankart lesions. Most bony Bankart lesions affected males between 40 and 75 years after low-energy falls and non-surgical treatment dominated.

Background

The glenohumeral joint is one of the most mobile joints in the human body and is, therefore, one of the most unstable as well [1]. The most common type of glenohumeral instability is anterior, accounting for more than 90% of all shoulder dislocations [2, 3]. One of the most common associated injuries, following anterior shoulder dislocation, is the Bankart lesion [4]. This is an injury to the anterior–inferior glenoid labrum with or without a bone fragment, and it is usually associated with an inferior glenohumeral ligament (IGHL) complex injury [4]. A Bankart lesion, which includes a bone fragment, is usually called a bony Bankart [5]. A bony Bankart lesion occurs when the injury to the anterior glenoid labrum extends into the bony glenoid margin, creating a fracture line through the anterior–inferior part of the glenoid, and thereby reduces the area of the glenoid and increases the risk of subsequent instability [6,7,8,9,10]. Bony Bankart fragments can differ in size and form and can directly affect the stability of the shoulder by reducing the joint-contact area and congruency [11,12,13].

There is ample evidence of isolated soft-tissue Bankart lesions and risk factors predisposing to first-time or recurrent traumatic anterior shoulder dislocations [14]. It has been reported that, in younger age groups, this type of injury is more common in males, especially between 20 and 30 years of age, whereas, after the age of 50, it is considered more common among women [2, 15, 16]. The risk of recurrence after an anterior shoulder dislocation is high, particularly in younger patients, and can lead to osteoarthritis (OA) later in life [15]. Young patients with no concurrent fracture at the time of the primary shoulder dislocation have been shown to have a high risk of recurrence [16]. Moreover, the recurrence rate is highest in individuals aged ≤ 20 years, where nearly 50% will require surgical stabilisation [17].

There is a lack of consensus, and only limited data in the literature related to the treatment strategy for a bony Bankart injury. It is known that surgical treatment for large bony Bankart fragments (more than 20% of the glenoid width) plays a crucial role in improving patients’ clinical outcomes [18], and it has been shown to be a successful treatment strategy for athletes [19]. On the other hand, it has also been shown in some studies that even large and displaced glenoid rim fractures can be treated non-surgically [20, 21], especially when the glenohumeral joint is concentrically reduced [20, 22].

As a result, there is a need to collect more data in order to produce evidence relating to the most used treatment strategy for and epidemiology of bony Bankart lesions. High-quality epidemiological data will increase the understanding of this injury. This knowledge can be used for further studies related to fracture types in relation to treatment options.

The aim of this study is to report epidemiological data relating to bony Bankart lesions in Sweden using the Swedish fracture register. The purpose is to evaluate age and sex distribution in the population with bony Bankart lesions and its impact on treatment strategy and further to analyse patient-reported outcomes.

Materials and methods

Data from the Swedish fracture register (SFR) were extracted. The SFR was developed in 2009–2010 [23]. Data registration started in 2011 at the Sahlgrenska University Hospital. Since 2012, more departments in Sweden have been invited to join, and, in 2021, full national coverage was achieved among the 54 orthopaedic and trauma departments in the country. More than 300,000 fractures were registered in the SFR [24] by 2018.

In the SFR, the modified Euler and Rüedi classification, edited by Habermeyer in 1996, is used to classify different types of glenoid fracture [25]. Data are reported to the register by the treating physician at the emergency orthopaedic department. We defined a bony Bankart injury as all patients with a registered type D1a injury according to the modified Euler and Rüedi classification (Fig. 1).

Fig. 1
figure 1

Modified Euler and Rüedi classification of scapular fractures

Full size image

Data for these patients from 1 April 2012 to 1 April 2019 in the SFR were extracted.

Epidemiological data in terms of sex, age, cause of injury and type of treatment were collected from the SFR and analysed.

Injuries were classified based on trauma mechanism, as high- or low-energy trauma, based on the criteria from the ATLS guidelines [26]. A low-energy trauma is usually associated with injury mechanisms such as falling from standing height or less.

The type of treatment was divided into three groups: non-surgical, primary surgical or secondary surgical (when a primary decision to perform non-surgical treatment had been revised at an early stage).

The EQVAS score was used to evaluate patient-related outcomes [27]. This score ranges from 0 to 100, with 0 denoting the worst and 100 the best possible health state imaginable. The first measurement referred to as PROM0 presents patient quality of life before the injury, and the second measurement, PROM1, presents it 1 year after the injury. The first PROM was obtained using the recall technique during the 1st weeks after the fracture occurred.

The study was approved by Ethical Committee confirming that all methods were carried out in accordance with relevant guidelines and regulations (Dnr: 825-18).

Statistics

Categorical variable numbers (n) are presented in per cent. For continuous variables, the mean ± standard deviation (SD)/median value (range) in numbers is presented, depending on whether or not data were normally distributed. For comparisons between groups, Fisher’s exact test (lowest one-sided p value multiplied by 2) was used for dichotomous variables.

If no exact limits could be computed, the asymptotic Wald confidence limits with continuity correction were calculated instead. For comparisons within groups, the Wilcoxon signed-rank test was used. The IBM SPSS Statistics, Version 2, statistical software (SPSS Inc., Chicago, USA) was used.

Results

We identified 790 patients with unilateral bony Bankart injuries. Only one patient with a bilateral bony Bankart injury was reported and was not included in this study.

Epidemiology

Of 790 patients, 58.7% were male (Table 1). The median age for all patients at the time of injury was 57 years (Fig. 2). Females had a higher median age of 66 years, compared with males, 51 years.

Table 1 Median age and sex at the time of injury
Full size table
Fig. 2
figure 2

Distribution of BB injury per age interval

Full size image

In 721 (91.2%) of the patients, the trauma energy level was defined. Most of the bony Bankart lesions; 91.8% (662 of 721), were registered as a low-energy trauma.

A fall from the same level was the most common cause of injury or 494 (62.5%), while a fall from a height occurred in 83 (10.5%) of the patients. Traffic accidents accounted for 41 (5.2%) of all injuries.

Bony Bankart lesions occurred in the right shoulder in 404 (51.1%) and the left shoulder in 386 (48.9%) patients.

For the distribution of injuries over the year, please see Fig. 3. Thirty-five per cent of the injuries occurred during the first quarter of the year.

Fig.3
figure 3

Distribution of BB lesions per month

Full size image

Treatment strategy

More than two-thirds of all cases with registered treatment data (missing value in 56 patients), 509/734 patients (69.3%), were treated non-surgically; 225 (30.7%) were treated surgically. In 208, surgical treatment was primarily chosen and secondary in 17 patients (7.5%) when the treatment was changed from non-surgical to surgical, due to recurrent instability of the shoulder (Fig. 4). The median age of the patients in the surgical group was similar to that of the non-surgical group (55 vs. 58 years) (Table 2).

Fig. 4
figure 4

Type of treatment for the BB lesions (missing—56)

Full size image
Table 2 Median age of the patients for different treatment options (missing—56)
Full size table

Surgical treatment was chosen for 149 (35%) of males and 76 (25%) of females (Table 3).

Table 3 Treatment type distribution in relation to sex
Full size table

Bony Bankart lesions induced by high-energy trauma were more often treated surgically (Table 4 and Fig. 5), and 26 (48%) of the patients in the high-energy trauma group were treated surgically, compared with 175 (29%) in the low-energy trauma group.

Table 4 Choice of treatment for high- and low-energy-induced bony Bankart lesions
Full size table
Fig. 5
figure 5

Treatment options for high- and low-energy-induced BB injuries

Full size image

Patient quality of life decreased slightly in both the surgically and non-surgically treated groups 1 year after the bony Bankart injury (Table 5).

Table 5 Quality of life changes in the non-surgically and surgically treated groups
Full size table

Discussion

The most important finding of this study is the reporting of many epidemiological variables of this injury. This was made possible by the large data sample in the SFR.

The completeness of the SFR differs among fracture types, and there are no data that report the completeness of bony Bankart fractures, type D1a. Möller et al. have shown completeness of approximately 85% for hip and femur fractures and 70% for wrist fractures [28].

The present study shows that bony Bankart lesions are more frequent in the population over 50 years of age. This is contrary to primary anterior shoulder dislocation which usually occurs in the young population with the median age of 35 years [29]. One reason why a bony Bankart lesion is more typical in older patients could be biomechanical and biological changes leading to reduced elasticity of the joint capsule and possibly weaker bone quality at higher age [30, 31].

The prevalence of male gender in all types of primary anterior shoulder dislocation is around 70% [29, 32]. The present study shows minor predominance for bony Bankart lesions in males, 58.7%.

A simple, low-energy fall was one of the most common causes of this injury. This study further reveals a seasonal variation in the distribution of bony Bankart lesions. This type of injury is more common during the winter period, possibly related to slippery conditions.

Most bony Bankart lesions were treated non-surgically, particularly in females. This could be related to fracture size, the position of the fracture related to differences in ligament laxity, bone quality or other factors [31, 33]. The age of the patients did not affect the treatment strategy.

A higher prevalence of non-surgical treatment could be related to the relatively limited degree of dislocation of the bony Bankart fragment, a low complication rate and good bone-to-bone healing potential [34, 35]. Olds et al. reported a low risk of recurrent instability in the presence of a bony Bankart lesion [14]. Robinson et al. reported an increased risk of recurrence in the presence of a glenoid rim fracture during the first 6 weeks following a first-time traumatic anterior shoulder dislocation in only 3.2% of patients [36].

One-third of bony Bankart lesions; 225/734 (30.7%), were treated surgically, which is similar to previously published data on the treatment of soft-tissue Bankart lesions [37, 38]. In the present study, we found that the majority of the bony Bankart lesions were due to low-energy trauma and were mostly treated non-surgically (71% of all patients), compared with high-energy bony Bankart lesions, which were treated surgically to a greater extent. Almost half of the patients (48%) with bony Bankart lesions induced by high-energy trauma were treated surgically, which could be related to more dislocated and larger bony Bankart fragments due to high-energy forces.

It is difficult to draw any definitive conclusion in terms of patient quality of life 1 year after the injury due to the limited response rate. However, quality of life appears to decrease slightly in both groups, especially in the non-surgically treated group. These results were statistically significant, albeit not clinically relevant, since the minimal clinically important change on the EQVAS has been shown to supersede the attained values [39].

Moreover, we compared the data with previously published epidemiological studies based on the SFR analysing other types of fractures [40,41,42]. Some differences and common features were found. Most fractures had a similar seasonal variation with an increased number of injuries during the winter months and a higher incidence after the age of 40 years. The main difference between studies was the distribution of gender. The majority of bony Bankart lesions occurred in males and decreased dramatically after the age of 75 years compared with other fractures [40,41,42].

These results may suggest that bony Bankart injuries are probably not related to fragility or reduced bone mineral density.

There are several limitations to the present study. One of them was the low response rate in PROMS, especially at the 1-year follow-up. Another limitation is that the modified Euler and Rüedi classification could lead to misclassification, causing difficulties for surgeons to classify the fracture in some non-standard cases. The simplicity of this classification that has been used to classify different types of glenoid fracture in the SFR is an advantage, compared with the AO (Arbeitsgemeinschaft für Osteosynthesefragen) classification of scapular fractures from 2013. However, it is incomplete and can make it difficult to distinguish isolated anterior glenoid fractures with a large anterior fragment from bony Bankart lesions in several patients [43].

One of the main strengths of this study is the large amount of data from the Swedish fracture register, including non-surgically treated fractures. The current register-based study provides reliable data on bony Bankart epidemiology in Sweden.

Conclusion

This national register-based study provides detailed information on the epidemiology, choice of treatment and patient-reported outcomes in a large cohort of bony Bankart lesions. Most bony Bankart lesions affected males between 40 and 75 years of age after low-energy falls and were treated non-surgically.

Availability of data and materials

The datasets used and analysed during the current study are available from the corresponding author on reasonable request.

Abbreviations

IGHL:

Inferior glenohumeral ligament

OA:

Osteoarthritis

SFR:

Swedish fracture register

References

  1. Zacchilli MA, Owens BD. Epidemiology of shoulder dislocations presenting to emergency departments in the United States. J Bone Joint Surg. 2010;92-A(3):542–9.

    Article  Google Scholar 

  2. Hovelius L. Incidence of shoulder dislocation in Sweden. Clin Orthop Relat Res. 1982;166:127–31.

    Article  Google Scholar 

  3. Mazzocca AD, Cote MP, Solovyova O, Rizvi SH, Mostofi A, Arciero RA. Traumatic shoulder instability involving anterior, inferior, and posterior labral injury: a prospective clinical evaluation of arthroscopic repair of 270° labral tears. Am J Sports Med. 2011;39(8):1687–96.

    Article  PubMed  Google Scholar 

  4. Spatschil A, Landsiedl F, Anderl W, Imhoff A, Seiler H, Vassilev I, et al. Posttraumatic anterior-inferior instability of the shoulder: arthroscopic findings and clinical correlations. Arch Orthop Trauma Surg. 2006;126(4):217–22.

    Article  CAS  PubMed  Google Scholar 

  5. Rowe CR, Patel D, Southmayd WW. The Bankart procedure: a long-term end-result study. J Bone Joint Surg. 1978;60-A(1):1–16.

    Article  Google Scholar 

  6. Ji JH, Kwak DS, Yang PS, Kwon MJ, Han SH, Jeong JJ. Comparisons of glenoid bony defects between normal cadaveric specimens and patients with recurrent shoulder dislocation: an anatomic study. J Shoulder Elbow Surg. 2012;21(6):822–7.

    Article  PubMed  Google Scholar 

  7. Griffith JF, Antonio GE, Yung PS, Wong EM, Yu AB, Ahuja AT, et al. Prevalence, pattern, and spectrum of glenoid bone loss in anterior shoulder dislocation: CT analysis of 218 patients. AJR Am J Roentgenol. 2008;190(5):1247–54.

    Article  PubMed  Google Scholar 

  8. Porcellini G, Campi F, Paladini P. Arthroscopic approach to acute bony Bankart lesion. Arthroscopy. 2002;18(7):764–9.

    Article  PubMed  Google Scholar 

  9. Yiannakopoulos CK, Mataragas E, Antonogiannakis E. A comparison of the spectrum of intra-articular lesions in acute and chronic anterior shoulder instability. Arthroscopy. 2007;23(9):985–90.

    Article  PubMed  Google Scholar 

  10. Roberts SB, Beattie N, McNiven ND, Robinson CM. The natural history of primary anterior dislocation of the glenohumeral joint in adolescence. Bone Joint J. 2015;97-b(4):520–6.

    Article  CAS  PubMed  Google Scholar 

  11. Bollier MJ, Arciero R. Management of glenoid and humeral bone loss. Sports Med Arthrosc Rev. 2010;18(3):140–8.

    Article  PubMed  Google Scholar 

  12. Greis PE, Scuderi MG, Mohr A, Bachus KN, Burks RT. Glenohumeral articular contact areas and pressures following labral and osseous injury to the anteroinferior quadrant of the glenoid. J Shoulder Elbow Surg. 2002;11(5):442–51.

    Article  PubMed  Google Scholar 

  13. Matsen FA 3rd, Chebli C, Lippitt S. Principles for the evaluation and management of shoulder instability. J Bone Joint Surg. 2006;88-A(3):648–59.

    Article  Google Scholar 

  14. Olds M, Ellis R, Donaldson K, Parmar P, Kersten P. Risk factors which predispose first-time traumatic anterior shoulder dislocations to recurrent instability in adults: a systematic review and meta-analysis. Br J Sports Med. 2015;49(14):913–22.

    Article  CAS  PubMed  Google Scholar 

  15. Gordins V, Hovelius L, Sandström B, Rahme H, Bergstrom U. Risk of arthropathy after the Bristow-Latarjet repair: a radiologic and clinical thirty-three to thirty-five years of follow-up of thirty-one shoulders. J Shoudler Elbow Surg. 2015;24(5):691–9.

    Article  Google Scholar 

  16. Vermeiren J, Handelberg F, Casteleyn PP, Opdecam P. The rate of recurrence of traumatic anterior dislocation of the shoulder. A study of 154 cases and a review of the literature. Int Orthop. 1993;17(6):337–41.

    Article  CAS  PubMed  Google Scholar 

  17. Hovelius L, Olofsson A, Sandstrom B, Augustini BG, Krantz L, Fredin H, et al. Nonoperative treatment of primary anterior shoulder dislocation in patients forty years of age and younger. A prospective twenty-five-year follow-up. J Bone Joint Surg. 2008;90(5):945–52.

    Article  PubMed  Google Scholar 

  18. Park I, Lee JH, Hyun HS, Oh MJ, Shin SJ. Effects of bone incorporation after arthroscopic stabilization surgery for bony Bankart lesion based on preoperative glenoid defect size. Am Soc Sports Med. 2018;46(9):2177–84.

    Article  Google Scholar 

  19. Shah N, Nadiri MN, Torrance E, Funk L. Arthroscopic repair of bony Bankart lesions in collision athletes. Should Elb. 2018;10(3):201–6.

    Article  Google Scholar 

  20. Maquieira GJ, Espinosa N, Gerber C, Eid K. Non-operative treatment of large anterior glenoid rim fractures after traumatic anterior dislocation of the shoulder. J Bone Joint Surg. 2007;89-B(10):1347–51.

    Article  Google Scholar 

  21. Wieser K, Waltenspül M, Ernstbrunner L, Ammann E, Nieuwland A, Eid K, et al. Nonoperative treatment of anterior glenoid rim fractures after first-time traumatic anterior shoulder dislocation: a study with 9-year follow-up. JBJS Open Access. 2020;5(4). https://doi.org/10.2106/JBJS.OA.20.00133.

  22. van Oostveen DP, Temmerman OP, Burger BJ, van Noort A, Robinson M. Glenoid fractures: a review of pathology, classification, treatment and results. Acta Orthop Belg. 2014;80(1):88–98.

    PubMed  Google Scholar 

  23. Wennergren D, Ekholm C, Sandelin A, Möller M. The Swedish fracture register: 103,000 fractures registered. BMC Muskuloskel Disord. 2015;16:338.

    Article  Google Scholar 

  24. Wennergren D, Möller M. Implementation of the Swedish fracture register. Unfallchirurg. 2018;121(12):949–55.

    Article  PubMed  PubMed Central  Google Scholar 

  25. Wiedemann E. Fractures of the scapula. Unfallchirurg. 2004;107(12):1124–33.

    Article  CAS  PubMed  Google Scholar 

  26. Subcommittee AT, International ATLS Working Group--CHK WIRTH 26 REF. Advanced trauma life support (ATLS®): the ninth edition. J Trauma Acute Care Surg. 2013;74(5):1363–6.

    Google Scholar 

  27. Brooks R. EuroQol: the current state of play. Health Policy. 1996;37(1):53–72.

    Article  CAS  PubMed  Google Scholar 

  28. Möller M, Wolf O, Bergdahl C, Mukka S, Rydberg EM, Hailer NP, et al. The Swedish fracture register—ten years of experience and 600,000 fractures collected in a National Quality Register. BMC Muskuloskel Disord. 2022;23(1):141.

    Article  Google Scholar 

  29. Leroux T, Wasserstein D, Veillette C, Khoshbin A, Henry P, Chahal J, et al. Epidemiology of primary anterior shoulder dislocation requiring closed reduction in Ontario. Canada Am J Sports Med. 2014;42(2):442–50.

    Article  PubMed  Google Scholar 

  30. Buckwalter JA-Y, Woo SL. Age-related changes in ligaments and joint capsules: implications for participation in sports. Sports Med Arthrosc Rev. 1996;4(3):250–62.

    Article  Google Scholar 

  31. Huston LJ, Wojtys EM. Neuromuscular performance characteristics in elite female athletes. Am J Sports Med. 1996;24(4):427–36.

    Article  CAS  PubMed  Google Scholar 

  32. Shah A, Judge A, Delmestri A, Edwards K, Arden NK, Prieto-Alhambra D, et al. Incidence of shoulder dislocations in the UK, 1995–2015: a population-based cohort study. BMJ Open. 2017;7(11):e016112.

    Article  PubMed  PubMed Central  Google Scholar 

  33. Tosi LL, Boyan BD, Boskey AL. Does sex matter in musculoskeletal health? A workshop report. Orthop Clin N Am. 2006;37(4):523–9.

    Article  Google Scholar 

  34. Ernstbrunner L, De Nard B, Olthof M, Beeler S, Bouaicha S, Gerber C, et al. Long-term results of the arthroscopic bankart repair for recurrent anterior shoulder instability in patients older than 40 years: a comparison with the open Latarjet procedure. Am J Sports Med. 2020;48(9):2090–6.

    Article  PubMed  Google Scholar 

  35. Vermeulen AE, Landman EBM, Veen EJD, Nienhuis S, Koorevaar CT. Long-term clinical outcome of arthroscopic Bankart repair with suture anchors. J Shoulder Elbow Surg. 2019;28(5):e137–43.

    Article  PubMed  Google Scholar 

  36. Robinson CM, Kelly M, Wakefield AE. Redislocation of the shoulder during the first six weeks after a primary anterior dislocation: risk factors and results of treatment. J Bone Jount Surg. 2002;84-A(9):1552–9.

    Article  Google Scholar 

  37. Leland DP, Bernard CD, Keyt LK, Krych AJ, Dahm DL, Sanchez-Sotelo J, et al. An age-based approach to anterior shoulder instability in patients under 40 years old: analysis of a US population. Am J Sports Med. 2020;48(1):56–62.

    Article  PubMed  Google Scholar 

  38. Hovelius L, Rahme H. Primary anterior dislocation of the shoulder: long-term prognosis at the age of 40 years or younger. Knee Surg Sports Traumatol Arthrosc. 2016;24(2):330–42.

    Article  PubMed  Google Scholar 

  39. Paulsen A, Roos EM, Pedersen AB, Overgaard S. Minimal clinically important improvement (MCII) and patient-acceptable symptom state (PASS) in total hip arthroplasty (THA) patients 1 year postoperatively. Acta Orthop. 2014;85(1):39–48.

    Article  PubMed  PubMed Central  Google Scholar 

  40. Rundgren J, Bojan A, Mellstrand Navarro C, Enocson A. Epidemiology, classification, treatment and mortality of distal radius fractures in adults: an observational study of 23,394 fractures from the national Swedish fracture register. BMC Muskuloskel Disord. 2020;21(1):88.

    Article  Google Scholar 

  41. Mattisson L, Bojan A, Enocson A. Epidemiology, treatment and mortality of trochanteric and subtrochanteric hip fractures: data from the Swedish fracture register. BMC Muskuloskel Disord. 2018;19(1):369.

    Article  Google Scholar 

  42. Bergdahl C, Ekholm C, Wennergren D, Nilsson F, Möller M. Epidemiology and patho-anatomical pattern of 2011 humeral fractures: data from the Swedish fracture register. BMC Muskuloskel Disord. 2016;17:159.

    Article  Google Scholar 

  43. Marsh JL, Slongo TF, Agel J, Broderick JS, Creevey W, DeCoster TA, et al. Fracture and dislocation classification compendium - 2007: Orthopaedic Trauma Association classification, database and outcomes committee. J Orthop Trauma. 2007;21(10 Suppl):S1-133.

    Article  CAS  PubMed  Google Scholar 

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Funding

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Authors and Affiliations

  1. Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, 413 45, Gothenburg, Sweden

    Vladislavs Gordins, Mikael Sansone, Baldur Thorolfsson, Michael Möller, Malin Carling & Nicklas Olsson

  2. Department of Orthopaedics, Sahlgrenska University Hospital, Göteborgsvägen 31, 431 80, Mölndal, Sweden

    Vladislavs Gordins, Mikael Sansone, Baldur Thorolfsson, Michael Möller, Malin Carling & Nicklas Olsson

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Correspondence to Vladislavs Gordins.

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Ethic approval and consent to participate

In Sweden, informed consent is not required in order to be part of a national registry such as the one we have used in the present study. This is clearly stated in Swedish law. The following paragraphs underline this fact. (Chapter 7 of the Swedish Patient Data Act (2008:355)). This is also part of the ethical approval for the present study which has been approved by the Swedish ethical review authority so thereby the waiving of the consent is also approved by the Swedish ethical review authority. The present study was approved by Gothenburg Ethical Committee on 28 November 2018 (Dnr: 825-18). All patients who are registered in the SFR receive according to Swedish legislation information about their registration and are given the option of withdrawing (opt-out). Written consent is not needed for registering patients in national quality registers in Sweden. The data from SFR were fully anonymised before data analysis begun. The study was approved by Ethical Committee confirming that all methods were carried out in accordance with relevant guidelines and regulations.

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Gordins, V., Sansone, M., Thorolfsson, B. et al. Incidence of bony Bankart lesions in Sweden: a study of 790 cases from the Swedish fracture register. J Orthop Surg Res 18, 680 (2023). https://doi.org/10.1186/s13018-023-04173-x

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Journal of Orthopaedic Surgery and Research

ISSN: 1749-799X