Pectoralis Major Repair With Cortical Button Technique

Abstract

Pectoralis major tendon ruptures can lead to significant functional deficits that affect high-level athletic and labor-intensive activities. In active populations operative repair of the ruptured pectoralis major tendon has shown significant advantages over nonoperative treatment. We describe a novel surgical technique for pectoralis major repair with tension button fixation. This study included 12 recreational athletes and 2 professional athletes. The initial results were measured subjectively after a minimum of 6 months by the Single Assessment Numeric Evaluation score, the American Shoulder and Elbow Surgeons score, and the ability to return to the patient's sport at a preinjury level. Objectively, strength was measured with resisted horizontal adduction of the arm for both repaired and contralateral sides. Of the 12 recreational patients, 8 returned to their sport at preinjury levels, and the 2 professional athletes returned to their sport at full capacity in the National Football League. The mean Single Assessment Numeric Evaluation score was 87, and the mean American Shoulder and Elbow Surgeons scores were 99 for both the operative and contralateral sides. Isokinetic strength testing showed no significant differences between the operative and nonoperative sides. Patients with pectoralis major tendons repaired with the proposed tensioned cortical button technique had excellent results. This new technique provides a reliable method of repair in an efficient and safe manner.

Outcomes and Return to Sport After Pectoralis Major Tendon Repair: A Systematic Review

“…Older studies more frequently used bone tunnels, 18,28,30 while recent studies more commonly reported the use of cortical button fixation. 6,16,27 The majority of pectoralis major ruptures reported in the literature were complete tears, with 59% (242/413) of ruptures in this review described as complete, while 41% (171/413) were partial tears. Pectoralis major ruptures more frequently occurred at the sternal head than the clavicular head, with 55% (187/341) of cases reporting a rupture of both sternal and clavicular heads, 44% (149/341) involving only the sternal head, and 1% (5/341) affecting only the clavicular head; 47% (175/372) of ruptures were at the humeral insertion, 41% (154/372) of ruptures were at the musculotendinous junction, 8% (28/372) of tears were intratendinous, 3% (12/372) were at the muscle belly, less than 1% (2/372) of ruptures included a bony avulsion of the tendon, and less than 1% (1/372) of ruptures occurred at the sternal origin.…”

Eficaz solución quirúrgica a una rotura completa del pectoral mayor

“…A los 3 meses, el objetivo es haber conseguido un rango de movilidad completo y comenzar los ejercicios contra resistencia. Los deportes de contacto o el levantamiento de pesas, se iniciaran pasados los primeros 6 meses (15) .…”

Surgical Treatment of Pectoralis Major Muscle Ruptures: A Systematic Review and Meta-analysis

“…The sutures are then run through the tendon. 25,34,45,46,71 A similar technique using bicortical fixation with endobuttons has also been described. 59,78…”