Rupture of the Pectoralis Major Muscle

Abstract

Early surgical treatment by anatomic repair gives the best results in the treatment of total and near-total ruptures of the pectoralis major muscle.

Pectoralis Major Repair With Unicortical Button Fixation And Suture Tape

“…15,16 Although conservative management has been noted to be appropriate in a subset of patients with pectoralis major ruptures, operative treatment is indicated in all young, active patients, regardless of the chronicity of the injury. 1,15,17 Bak et al 15 performed a meta-analysis of 112 cases and reported excellent results in 88% of surgically treated patients with ruptures, compared excellent result in only 27% of patients with ruptures treated nonoperatively. Regardless of significantly better outcomes stemming from operative treatment, a case-by-case approach should be undertaken for each patient presenting with a pectoralis major rupture during treatment decision making.…”

“…At the insertion site on the humeral shaft, the muscle displays a triangular shape. 1,2 The fibers of the diverging layers of tendon, which make up each individual head, twist from their respective origins before coalescing at the insertion site on the humerus. [2][3][4][5][6] Although the main function of the muscle is adduction, the pectoralis major is also responsible for internal rotation, extension, and forward flexion.…”

“…7 Although mild strains or partial tears can be successfully treated with conservative management, surgical treatment is indicated for total ruptures to avoid loss of strength during adduction, forward flexion, and internal rotation of the extremity. 1 As a result of low functional demands, however, elderly and less active patients with a pectoralis major rupture may be conservatively treated. 10,11 The objective of this Technical Note is to describe our preferred technique for acute pectoralis major rupture repair involving use of cortical buttons for tendon stump-to-bone fixation.…”

Complete Avulsion of the Pectoralis Major Tendon: a Case Report

“…To our knowledge, only approximately 200 cases have been reported in the English literature [1,2]. The pectoralis major is a broad, thick and fan-shaped muscle, originating from the anterior surface of the medial end of the clavicle, the lateral half of the sternum as low down as the cartilaginous attachments of the sixth or seventh rib, the cartilages of all true ribs (with the exception, frequently, of the first or seventh), and from the aponeurosis of the obliquus externus abdominis.…”

“…However, the distinction between a partial or complete rupture is of great importance for deciding optimal management. While conservative therapy is justified for partial ruptures [6,13], early surgical management is recommended for a complete rupture [1,2]. Additional investigations like roentgenography and ultrasonography can be helpful, but are usually inconclusive in determining the extent and site of injury.…”