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Pectoralis Major Ruptures

  • Usman Butt
  • Puneet Monga
Chapter

Abstract

Ruptures of the pectoralis major tendon have traditionally been considered a rare injury, but there has been a rise in the number of reported cases over the last decade. The majority of cases occur in young adult males engaging in strenuous sporting activities such as weight training, and there is an association with the use of anabolic steroids. A thorough understanding of the mechanisms and presenting features with an early referral for specialist assessment and treatment can improve long-term outcomes. Early surgical treatment is the preferred management option in the majority of cases with non-operative management considered for late presentation, partial tears, muscle belly tears, and those occurring in the frail and low-demand subgroup of patients.

Keywords

Pectoralis major Tendon rupture Bench press Anabolic steroids Sports injury Bench press Soft tissue injury 

References

  1. 1.
    Butt U, Mehta S, Funk L, Monga P. Pectoralis major ruptures: a review of current management. J Shoulder Elb Surg. 2015;24(4):655–62.CrossRefGoogle Scholar
  2. 2.
    ElMaraghy AW, Devereaux MW. A systematic review and comprehensive classification of pectoralis major tears. J Shoulder Elb Surg. 2012;21:412–22.CrossRefGoogle Scholar
  3. 3.
    Hasegawa K, Schofer JM. Rupture of the pectoralis major: a case report and review. J Emerg Med. 2010;38:196–200.CrossRefGoogle Scholar
  4. 4.
    Petilon J, Ellingson CI, Sekiya JK. Pectoralis major muscle ruptures. Oper Tech Sports Med. 2005;13:162–8.CrossRefGoogle Scholar
  5. 5.
    Fung L, Wong B, Ravichandiran K, Agur A, Rindlisbacher T, Elmaraghy A. Three-dimensional study of pectoralis major muscle and tendon architecture. Clin Anat. 2009;22:500–8.CrossRefGoogle Scholar
  6. 6.
    Metzger PD, Bailey JR, Filler RD, Waltz RA, Provencher MT, Dewing CB. Pectoralis major muscle rupture repair: technique using unicortical buttons. Arthrosc Tech. 2012;1:e119–25.CrossRefGoogle Scholar
  7. 7.
    Provencher CDRMT, Handfield K, Boniquit NT, Reiff SN, Sekiya JK, Romeo AA. Injuries to the pectoralis major muscle diagnosis and management. Am J Sports Med. 2010;38:1693–705.CrossRefGoogle Scholar
  8. 8.
    Rabuck SJ, Lynch JL, Guo X, et al. Biomechanical comparison of 3 methods to repair pectoralis major ruptures. Am J Sports Med. 2012;40:1635–40.CrossRefGoogle Scholar
  9. 9.
    Wolfe SW, Wickiewicz TL, Cavanaugh JT. Ruptures of the pectoralis major muscle an anatomic and clinical analysis. Am J Sports Med. 1992;20:587–93.CrossRefGoogle Scholar
  10. 10.
    Merolla G, Paladini P, Artiaco S, Tos P, Lollino N, Porcellini G. Surgical repair of acute and chronic pectoralis major tendon rupture: clinical and ultrasound outcomes at a mean follow-up of 5 years. Eur J Orthop Surg Traumatol. 2015;25(1):91–8.CrossRefGoogle Scholar
  11. 11.
    Ohashi K, El-Khoury GY, Albright JP, Tearse DS. MRI of complete rupture of the pectoralis major muscle. Skelet Radiol. 1996;25:625–8.CrossRefGoogle Scholar
  12. 12.
    Zeman SC, Rosenfeld RT, Lipscomb PR. Tears of the pectoralis major muscle. Am J Sports Med. 1979;7:343–7.CrossRefGoogle Scholar
  13. 13.
    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;413:164–9.CrossRefGoogle Scholar
  14. 14.
    Inhofe PD, Grana WA, Egle D, Min K-W, Tomasek J. The effects of anabolic steroids on rat tendon an ultrastructural, biomechanical, and biochemical analysis. Am J Sports Med. 1995;23:227–32.CrossRefGoogle Scholar
  15. 15.
    Tsitsilonis S, Panayiotis CE, Athanasios MS, et al. Anabolic androgenic steroids reverse the beneficial effect of exercise on tendon biomechanics: an experimental study. Foot Ankle Surg. 2014;20(2):94–9.CrossRefGoogle Scholar
  16. 16.
    Bak K, Cameron EA, Henderson IJP. Rupture of the pectoralis major: a meta-analysis of 112 cases. Knee Surg Sports Traumatol Arthrosc. 2000;8:113–9.CrossRefGoogle Scholar
  17. 17.
    Shah NH, Talwalker S, Badge R, Funk L. Pectoralis major rupture in athletes: footprint technique and results. Tech Should Elbow Surg. 2010;11:4–7.CrossRefGoogle Scholar
  18. 18.
    Lee J, Brookenthal KR, Ramsey ML, Kneeland JB, Herzog R. MR imaging assessment of the pectoralis major myotendinous unit: an MR imaging—anatomic correlative study with surgical correlation. Am J Roentgenol. 2000;174:1371–5.CrossRefGoogle Scholar
  19. 19.
    Tietjen R. Closed injuries of the pectoralis major muscle. J Trauma Acute Care Surg. 1980;20:262–4.CrossRefGoogle Scholar
  20. 20.
    Schepsis AA, Grafe MW, Jones HP, Lemos MJ. Rupture of the pectoralis major muscle outcome after repair of acute and chronic injuries. Am J Sports Med. 2000;28:9–15.CrossRefGoogle Scholar
  21. 21.
    Hanna CM, Glenny AB, Stanley SN, Caughey MA. Pectoralis major tears: comparison of surgical and conservative treatment. Br J Sports Med. 2001;35:202–6.CrossRefGoogle Scholar
  22. 22.
    Sherman SL, Lin EC, Verma NN, et al. Biomechanical analysis of the pectoralis major tendon and comparison of techniques for tendo-osseous repair. Am J Sports Med. 2012;40(8):1887–94.CrossRefGoogle Scholar
  23. 23.
    de Castro Pochini A, Ejnisman B, Andreoli CV, et al. Pectoralis major muscle rupture in athletes a prospective study. Am J Sports Med. 2010;38:92–8.CrossRefGoogle Scholar
  24. 24.
    Joseph TA, DeFranco MJ, Weiker GG. Delayed repair of a pectoralis major tendon rupture with allograft: a case report. J Shoulder Elb Surg. 2003;12:101–4.CrossRefGoogle Scholar
  25. 25.
    Schachter AK, White BJ, Namkoong S, Sherman O. Revision reconstruction of a pectoralis major tendon rupture using hamstring autograft a case report. Am J Sports Med. 2006;34:295–8.CrossRefGoogle Scholar
  26. 26.
    Sikka RS, Neault M, Guanche CA. Reconstruction of the pectoralis major tendon with fascia lata allograft. Orthopedics. 2005;28:1199–202.PubMedGoogle Scholar
  27. 27.
    Zacchilli MA, Fowler JT, Owens BD. Allograft reconstruction of chronic pectoralis major tendon ruptures. J Surg Orthop Adv. 2012;22:95–102.Google Scholar
  28. 28.
    Zafra M, Muñoz F, Carpintero P. Chronic rupture of the pectoralis major muscle: report of two cases. Acta Orthop Belg. 2005;71:107–10.PubMedGoogle Scholar

Copyright information

© Springer Nature Switzerland AG 2020

Authors and Affiliations

  • Usman Butt
    • 1
  • Puneet Monga
    • 1
  1. 1.Wrightington Upper Limb Unit, Wrightington HospitalWiganUK

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