Complete Avulsion of the Pectoralis Major Tendon: a Case Report

Li, Wilson W.L.; Jonge, Milko C. de; Goslings, Carel; Haverlag, Robert; Ponsen, Kees-Jan

doi:10.1007/s00068-007-6103-z

Cited by 3 publications

(2 citation statements)

References 16 publications

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“…The articles that were clearly unrelated to the topic for review were removed (3,173), leaving 230 articles for full review. Of these 230 articles, 140 were included in this critical analysis for detailed review; 81 articles were evaluated to compile the descriptive review 10-89 . The majority of articles were small case series (68) and individual case reports, and a few were large series (prospective and retrospective).…”

Section: Methodsmentioning

confidence: 99%

Pectoralis Major Tendon Tear

Magone

Ben-Ari

Gyftopoulos³

et al. 2021

JBJS Reviews

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Pectoralis major (PM) tendon tears are predominantly seen in young men, and the majority of tears occur as tendon avulsions involving the sternal head. Weightlifting, specifically bench-pressing, and sporting activities with eccentric overloading of the PM tendon are the 2 most common activities that result in PM injury.Early surgical repair or reconstruction should be offered to younger, active patients with a complete PM tear; the majority of the patients undergoing surgical repair achieve good-to-excellent outcomes.Nonsurgical treatment of a complete PM tear is an option but will result in cosmetic deformity and a deficit in adduction strength of the arm. Outcomes after nonsurgical treatment of complete PM tears are less satisfactory than those obtained after surgical treatment.Currently, there is no consensus on the chronological definition of PM tears (acute versus chronic), the critical time limit for performing surgical repair, the ideal fixation device (cortical button, bone tunnel, or suture anchors), the indications for allograft use, and the ideal rehabilitation protocol after treatment of PM tears.

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Section: Methodsmentioning

confidence: 99%

Pectoralis Major Tendon Tear

Magone

Ben-Ari

Gyftopoulos³

et al. 2021

JBJS Reviews

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“…∥References 2, 3, 5, 7, 8, 10, 12, 16 -19, 23, 28, 31, 35, 37, 40, 42, 48, 50, 52, 54, 58, 59, 61, 62, 64 -67, 69, 70, 72, 77, 79 -84, 86, 87.…”

mentioning

confidence: 99%

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

Gupton

Johnson

2019

Orthopaedic Journal of Sports Medicine

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Background:Pectoralis major muscle (PMM) tendon ruptures are becoming more common. Multiple techniques for fixation of the avulsed tendon to its humeral insertion have been described. None of these techniques has been reviewed to compare outcomes in efforts to establish a first-line surgical technique.Purpose:To systematically review and analyze the data available in the literature to establish a clinically superior surgical technique and time frame in which surgery should occur.Study Design:Systematic review; Level of evidence, 4.Methods:A systematic literature review was conducted. Only studies reporting the surgical techniques and outcomes of PMM repair were included. Data including patient age, injury mechanism, type and extent of the rupture, time from injury to surgery, surgical technique, outcome including complications, steroid use, location and year of publication, and activity level were extracted from the included studies. Statistical and descriptive analyses were conducted on the available literature.Results:Of 259 cases from studies that provided the timing of repair, 72.6% (n = 188) were repaired acutely, while the remaining were repaired more than 8 weeks after the injury. There was no statistical difference found in the outcomes of these repairs. There were 265 cases included in the statistical analysis comparing the outcomes of surgical techniques. The odds of an excellent/good outcome were significantly better for the transosseous suture (TOS) compared with the unicortical button (UCB) technique (odds ratio [OR], 6.28 [95% CI, 1.37-28.75]; P = .018) and also for the suture anchor (SA) compared with the UCB technique (OR, 3.40 [95% CI, 1.06-10.85]; P = .039). The odds of an excellent/good outcome were not significantly different when comparing the TOS, SA, and TOS with trough techniques to one another. The probability of complications was highest with the TOS with trough technique (12.0%), although the odds of having a complication were not statistically significant for any single technique compared with the others.Conclusion:The low quality of evidence available limited this review. There were no significant differences observed in the outcomes of PMM repair based on the timing of repair. The TOS and SA techniques had statistically significantly greater odds of resulting in an excellent/good outcome compared with the UCB technique, but 1 study that contributed to this analysis may have statistically skewed the results for the UCB technique. Therefore, all 3 surgical techniques are accepted options, and the best technique is that with which the surgeon is most proficient and comfortable. Comparative research with a greater level of evidence is needed to determine a definitive first-line surgical technique.

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