Anatomic evaluation of the subcoracoid pectoralis major transfer in human cadavers

Klepps, Steven; Goldfarb, Charles A.; Flatow, Evan L.; Galatz, Leesa M.; Yamaguchi, Ken

doi:10.1067/mse.2001.117125

Cited by 71 publications

(53 citation statements)

References 18 publications

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“…Tendon transfers, more specifically, have been applied for the repair of winging of the scapula (e.g., following serratus anterior weakness due to long thoracic nerve palsy) and glenohumeral joint instability (e.g., following subscapularis rupture) (Galano et al, 2008;Tauber et al, 2008;Jennings et al, 2007;Galatz et al, 2003). Although both methods have been documented, partial transfer of the split pectoralis remains the preferred technique as it may infer a lower risk of neurapraxia relative to a full tendon transfer (Klepps et al, 2001). Splitting the PM has been described from two approaches, which broadly include techniques from the tendon (Jennings et al, 2007) or those from the intramuscular septum dividing the CH and SH (Tauber et al, 2008, Galano et al, 2008.…”

Section: Discussionmentioning

confidence: 98%

Three‐dimensional study of pectoralis major muscle and tendon architecture

Fung¹,

Wong²,

Ravichandiran³

et al. 2009

Clinical Anatomy

100

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A thorough understanding of the normal structural anatomy of the pectoralis major (PM) is of paramount importance in the planning of PM tendon transfers or repairs following traumatic PM tears. However, there is little consensus regarding the complex musculotendinous architecture of the PM in the anatomic or surgical literature. The purpose of this study is to model and quantify the three-dimensional architecture of the pectoralis muscle and tendon. Eleven formalin embalmed cadaveric specimens were examined: five (2M/3F) were serially dissected, digitized, and modeled in 3D using Autodesk Maya; six (4M/2F) were dissected and photographed. The PM tendon consisted of longer anterior and shorter posterior layers that were continuous inferiorly. The muscle belly consisted of an architecturally uniform clavicular head (CH) and a segmented sternal head (SH) with 6-7 segments. The most inferior SH segment in all specimens was found to fold anteriorly forming a trough that cradled the inferior aspect of the adjacent superior segment. No twisting of either the PM muscle or tendon was noted. Within the CH, the fiber bundle lengths (FBL) were found to increase from superior to inferior, whereas the mean FBLs of SH were greatest in segments 3-5 found centrally. The mean lateral pennation angle was greater in the CH (29.4 +/- 6.9 degrees ) than in the SH (20.6 +/- 2.7 degrees ). The application of these findings could form the basis of future studies to optimize surgical planning and functional recovery of repair/reconstruction procedures.

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Section: Discussionmentioning

confidence: 98%

Three‐dimensional study of pectoralis major muscle and tendon architecture

Fung¹,

Wong²,

Ravichandiran³

et al. 2009

Clinical Anatomy

100

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show abstract

“…The LPN exhibits a nearly straight course along the pectoral branches of the thoracoacromial artery, on the undersurface of the upper portion of the PM muscle, passing medially to the pectoralis minor before entering the PM muscle [28,36,41,46]. The length of the nerve's course along the deep surface of the PM muscle and under its fascia has been calculated as 55 ± 7 mm [36].…”

Section: Course and Branches Of The Lpnmentioning

confidence: 99%

Anatomical study of the articular branch of the lateral pectoral nerve to the shoulder joint

Nam

Panchal

Kim

et al. 2015

Knee Surg Sports Traumatol Arthrosc

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“…Resch et al betonen, dass dies nicht dem ursprünglichen Verlauf der Subskapularissehne entspricht [9], und empfehlen, den Sehnenteil hinter der gemeinsamen Sehne des Caput breve musculi bicipitis und des Musculus coracobrachialis ("conjoined tendon") vorbeizuführen. Allerdings ist auch diese Technik nicht unumstritten, da hierbei die abgelöste Pectoralis-major-Sehne bei entsprechender Anatomie des Processus coracoideus den Nervus musculocutaneus bedrängen und schädigen kann [8].…”

Section: Introductionunclassified

“…Resch et al emphasize that this does not correspond to the original course of the subscapularis tendon [9] and recommend that the clavicular part be passed behind the conjoined tendon of the short head of the biceps and coracobrachialis. However, this technique is not undisputed since, depending on the anatomy of the coracoid process, the detached pectoralis major tendon may displace and damage the musculocutaneous nerve [8].…”

Section: Introductionmentioning

confidence: 99%