Muscle Ruptures of the Shoulder Girdle

  • Ewan Bigsby
  • Alex A. Malone


Complete muscle ruptures around the shoulder (excluding the rotator cuff) are rare. Current literature consists mainly of case reports and small case series, although a meta-analysis and systematic review have been published for Pectoralis Major tears.

The primary investigation of suspected muscle rupture is a plain radiograph to exclude bony involvement, an ultrasound may alert the clinician to the possible diagnosis and an MRI is the definitive investigation to determine key aspects of the injury pathology.

The majority of Pectoralis Major ruptures in the young population are repaired with good functional results. Latissimus Dorsi ruptures have been treated both operatively and non-operatively with good results and the single case of a Teres Major rupture that was treated operatively did no better than the majority of patients who recovered well with non-operative treatment. Acute Deltoid ruptures have been treated effectively both operatively and non-operatively. Management depends upon symptom severity and, degree of rupture. Deltoid ruptures in the elderly population are often associated with massive rotator cuff tears. Serratus Anterior tears are predominantly treated non-operatively. Coracobrachilais tears are rare but when identified are treated surgically.

Given the relative lack of high level evidence for the majority of muscle ruptures around the shoulder treatment should be selected on an individual basis after discussion with the patient.


Muscle Rupture Tear Pectoralis major Latissimus dorsi Teres major Deltoid Serratus anterior Coracobrachialis 


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© Springer Nature Switzerland AG 2019

Authors and Affiliations

  • Ewan Bigsby
    • 1
  • Alex A. Malone
    • 1
  1. 1.University of OtagoChristchurchNew Zealand

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