Bilateral asymmetric deficiency of the pectoralis major muscle

Mosconi, Tony; Kamath, Sylvia

doi:10.1002/ca.10077

Cited by 27 publications

(35 citation statements)

References 4 publications

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“…There are reports of absence of the pectoralis major muscle abdominal portion on its own [1], or combined with absence of the lower part of its sternocostal portion [25]. In the case reported by Clark [25] the pectoralis minor muscle was also absent, whereas total aplasia of the pectoralis major has also been reported [24].…”

Section: Literature Reviewmentioning

confidence: 77%

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Abnormal muscles that may affect axillary lymphadenectomy: surgical anatomy

Natsis

Vlasis

Totlis

et al. 2009

Breast Cancer Res Treat

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Purpose The present study aimed at summarizing and presenting the anomalous muscles that a surgeon might encounter during axillary lymphadenectomy (AL). Methods For this purpose, both the anatomical and surgical literature was reviewed and an anatomical study on 107 cadavers was carried out. Furthermore, based on the anatomical features of the anomalous muscles that came up during our study and taking into consideration the landmarks of the AL, we further analyzed the complications that may arise from each of these muscles, along with their preoperative and intraoperative recognition and management. Results The literature review revealed that there are three supernumerary muscles that may affect the AL, namely the Langer's axillary arch, the pectoralis quartus and the chondroepitrochlearis muscles, as well as the aplasia of the lower part of the pectoralis major muscle. Eight out of the 107 (7.48%) cadavers that we dissected had such an abnormal muscle in the axilla. Specifically, the axillary arch was found unilaterally in five cadavers (4.67%) and the pectoralis quartus muscle was present unilaterally in three cadavers (2.8%). One cadaver had both an axillary arch and a pectoralis quartus muscle in the right side. The abdominal and almost the whole sternocostal portion of the pectoralis major as well the pectoralis minor muscle were absent in one cadaver (0.93%). The chondroepitrochlearis muscle was not found in any of the cadavers that we dissected. Conclusions The present study offers the necessary preoperative knowledge for recognizing these muscles during AL, avoiding thus the complications that may arise from them.

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Section: Literature Reviewmentioning

confidence: 77%

“…Pectoral muscles deformities have been reported to be present in about 1:5,000-1:11,000 [24]. There are reports of absence of the pectoralis major muscle abdominal portion on its own [1], or combined with absence of the lower part of its sternocostal portion [25].…”

Section: Literature Reviewmentioning

confidence: 99%

Abnormal muscles that may affect axillary lymphadenectomy: surgical anatomy

Natsis

Vlasis

Totlis

et al. 2009

Breast Cancer Res Treat

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“…Many anatomical variations, such as congenital absence of muscle parts or the presence of accessory muscles, may involve the pectoral girdle. In a case report with absence of the sternal portion of the pectoralis major muscle on one side and total absence of the pectoralis major on the other side bilateral selective absence of the LPNs has been reported (Mosconi and Kamath,2003). The presence of accessory muscles must be recognized during surgery of the region, such as axillary lymphadenectomy, to avoid complications (Natsis et al,2010).…”

Section: Pns In Anatomical Variations Of the Pectoral Girdle Musclesmentioning

confidence: 99%

Surgical anatomy of the pectoral nerves and the pectoral musculature

et al. 2011

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The pectoral nerves (PNs) may be selectively injured through various traumatic mechanisms such as direct trauma, hypertrophic muscle compression, and iatrogenic injuries (breast surgery and axillary node dissection, pectoralis major muscle transfers). The PN may be surgically recovered through nerve transfers. They may also be used as donors to the musculocutaneous, axillary, long thoracic, and spinal accessory nerves and for reinnervation of myocutaneous free flaps. Thus, in this article, we reviewed the surgical anatomy of PN. A meta-analysis of the available literature showed that the lateral pectoral nerve (LPN) arises most frequently with two branches from the anterior divisions of the upper and middle trunks (33.8%) or as a single root from the lateral cord (23.4%). The medial pectoral nerve (MPN) usually arises from the medial cord (49.3%), anterior division of the lower trunk (43.8%), or lower trunk (4.7%). The two PN are usually connected immediately distal to the thoracoacromial artery by the so-called ansa pectoralis. The MPN may also show communications with the intercostobrachial nerve. In 50%-100% of cases, it may pass, at least with some branches, through the pectoralis minor muscle. The LPN supplies the upper portions of the pectoralis major muscle; the MPN innervates the lower parts of the pectoralis major and the pectoralis minor muscle. Among the accessory muscles of the pectoral girdle, the LPN may also innervate the tensor semivaginae articulationis humero-scapularis, pectoralis minimus, sternoclavicularis, axillary arch, sternalis, and infraclavicularis muscles; the MPN may innervate the pectoralis quartus, chondrofascialis, axillary arch, chondroepitrochlearis, and sternalis muscles.

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“…As previously stated, the most common activity precipitating this injury is the bench press exercise, in which the arm is extended and externally rotated during maximal contraction. 5,12 Although a functional pectoralis major is not necessary for activities of daily living, 13 a fully intact muscle is required for those Once the repair is complete and the tension of the repair construct has been evaluated during range of motion of the right shoulder, a Double Syringe System (Greyledge Technologies, Vail, CO) (red arrow) (A) is used to inject a combination of autologous conditioned plasma (ACP) and platelet-rich plasma (PRP) at the interface between the tendon and humerus insertion site (red arrow) (B) to maximize the healing potential. who wish to continue weightlifting activities and other significant physical activity as well as labor that requires heavy lifting.…”

Section: Discussionmentioning

confidence: 99%

Pectoralis Major Repair With Unicortical Button Fixation And Suture Tape

Sanchez

Ferrari

Frangiamore

et al. 2017

Arthroscopy Techniques

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Although injuries of the pectoralis major muscle are generally uncommon, ruptures of the pectoralis major are occasionally seen in younger, more active patients who participate in weightlifting activities. These injuries usually occur during maximal contraction of the muscle, while in extension and external rotation. In the case of a rupture, operative treatment is advocated especially in young, active patients regardless of the chronicity of the injury. Various surgical techniques for reattachment of the avulsed tendon have been described, but bone tunnel and suture anchor repair techniques are most widely used. In this Technical Note, we present our preferred technique for acute pectoralis major rupture repair involving use of cortical buttons for tendon stump-to-bone fixation.

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Bilateral asymmetric deficiency of the pectoralis major muscle

Cited by 27 publications

References 4 publications

Abnormal muscles that may affect axillary lymphadenectomy: surgical anatomy

Abnormal muscles that may affect axillary lymphadenectomy: surgical anatomy

Surgical anatomy of the pectoral nerves and the pectoral musculature

Pectoralis Major Repair With Unicortical Button Fixation And Suture Tape

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