Effective surgical solution to a complete rupture of the pectoralis major

Authors

  • Cristian Pinilla-Gracia Hospital Universitario Miguel Servet (Zaragoza)
  • Luis Rodríguez-Nogué Hospital Universitario Miguel Servet (Zaragoza)
  • Alberto Hernández-Fernandez Hospital Universitario Miguel Servet (Zaragoza)
  • Carlos Martín Hernández Hospital Universitario Miguel Servet (Zaragoza)
  • Ignacio Carbonel-Bueno Hospital Universitario Miguel Servet (Zaragoza)
  • Jorge Ripalda-Marin Hospital Universitario Miguel Servet (Zaragoza)

DOI:

https://doi.org/10.31053/1853.0605.v76.n3.24282

Keywords:

pectoralis muscles, tendons, rupture, reconstruction

Abstract

Background: The rupture of the pectoralis major muscle is rare, occurring typically in young male athletes. When the break is complete and the patient active, surgical treatment is the choice.

Clinical case: 48-year-old man with severe pain in left shoulder after lifting weights. He presents impotence to adduction and internal rotation of the shoulder with thinning of the axillary fold. MRI confirms the diagnosis of complete rupture of the pectoralis major. Surgical treatment was decided, performing a deltopectoral approach and reinserting the pectoralis major tendon with three cortical buttons.

Conclusion: The rupture of the pectoralis major is a typical lesion of active young patients with an increasing incidence. Although there have been no significant differences between the different repair options, in our experience the use of cortical buttons provides very satisfactory results.

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Author Biographies

Cristian Pinilla-Gracia, Hospital Universitario Miguel Servet (Zaragoza)

 

Médico residente Cirugía Ortopédica y Traumatología.

Máster en Universidad de Zaragoza

Luis Rodríguez-Nogué, Hospital Universitario Miguel Servet (Zaragoza)

Médico residente Cirugía Ortopédica y Traumatología.

Máster en Universidad de Zaragoza

Alberto Hernández-Fernandez, Hospital Universitario Miguel Servet (Zaragoza)

Médico residente Cirugía Ortopédica y Traumatología.

Máster en Universidad de Zaragoza

Carlos Martín Hernández, Hospital Universitario Miguel Servet (Zaragoza)

Doctor en Medicina y Cirugía.

Jefe de Servicio Cirugía Ortopédica y Traumatología

Ignacio Carbonel-Bueno, Hospital Universitario Miguel Servet (Zaragoza)

Facultativo Especialista de Área Cirugía Ortopédica y Traumatología.

Doctor en Medicina y Cirugía.

Jorge Ripalda-Marin, Hospital Universitario Miguel Servet (Zaragoza)

Facultativo Especialista de Área Cirugía Ortopédica y Traumatología.

Doctor en Medicina y Cirugía.

References

El Maraghy AW, Devereaux MW. A systematic review and comprehensive classification of pectoralis major tears. J Shoulder Elbow Surg. 2012 Mar;21(3):412-22.

De Castro Pochini A, Andreoli CV, Belangero PS, et al. Clinical considerations for the surgical treatment of pectoralis major muscle ruptures based on 60 cases: a prospective study and literature review. Am J Sports Med. 2014 Jan;42(1):95-102.

Marmor L, Bechtol CO, Hall CB: Pectoralis major muscle: Function of sterna portion and mechanism of rupture of normal muscle: Case reports. J Bone Joint Surg Am 1961;43:81-87.

Tietjen R. Closed injuries of the pectoralis major muscle. JTrauma. 1980;20(3):262–4.

Verfaillie SM, Claes T. Bony avulsion of the pectoralis major muscle. J Shoulder Elbow Surg. 1996. Jul‐Aug;5(4):327‐9

Butt U, Mehta S, Funk L, Monga P. Pectoralis major ruptures: a review of current management. J Shoulder Elbow Surg 2015;24:655-62.

Beloosesky Y, Grinblat J, Weiss A, Rosenberg PH, Weisbort M, Hendel D. Pectoralis major rupture in elderly patients: A clinical study of 13 patients. Clin Orthop Relat Res 2003:164-169.

Lipman A, Strauss E. Treatment of pectoralis major muscle ruptures. Bull Hosp Jt Dis. 2016;74(1):63-72.

Haley CA, Zacchilli MA. Pectoralis major injuries: evaluation and treatment. Clinics Sports Med. 2014 Oct;33(4):739-56.

Edgar CM, Singh H, Obopilwe E, et al: Pectoralis major repair: A biomechanical analysis of modern repair configurations versus traditional repair configuration. Am J Sports Med. 2017; 45(12):2858-63.

Flint JH,Wade AM, Giuliani J, et al. Defining the terms acute and chronic in orthopaedic sports injuries: a systematic review. Am J Sports Med 2014;42:235–41.

Neumann, J. A., Klein, C. M., van Eck, C. F., Rahmi, H., & Itamura, J. M. (2017). Outcomes After Dermal Allograft Reconstruction of Chronic or Subacute Pectoralis Major Tendon Ruptures. Orthopaedic journal of sports medicine. 2017; 6(1), 2325967117745834.

Zacchilli MA, Fowler JT, Owens BD. Allograft reconstruction of chronic pectoralis major tendon ruptures. J Surg Orthop Adv 2013;22(1):95–102.

Guity M, Sharafat Vaziri A, Shafiei H, Farhoud A. Surgical treatment of pectoralis major tendon rupture (outcome assessment). Asian J Sports Med. 2014 Jun;5(2):129-35.

Kang RW, Mahony GT, Cordasco FA. Pectoralis major repair with cortical button technique. Arthrosc Tech. 2014 Jan;3(1):e73-7.

Published

2019-08-29

How to Cite

1.
Pinilla-Gracia C, Rodríguez-Nogué L, Hernández-Fernandez A, Martín Hernández C, Carbonel-Bueno I, Ripalda-Marin J. Effective surgical solution to a complete rupture of the pectoralis major. Rev Fac Cien Med Univ Nac Cordoba [Internet]. 2019 Aug. 29 [cited 2024 Jul. 17];76(3):185-8. Available from: https://revistas.unc.edu.ar/index.php/med/article/view/24282

Issue

Section

Case Report