[Current treatment options for complete ruptures of the pectoralis major tendon]

The rupture of the pectoralis major tendon is an uncommon pathological condition that is reported in literature to prevail among athletes, although also case reports and case series of nursing home residents or workers can be found, as well as traumatic lesions. Among athletes, pectoralis major tendon ruptures have shown a significant increase in incidence over the last years. This may be due to the higher number of individuals taking part in high-impact sports and weight-lifting. In the recent literature, there are only few recommendations to rely on conservative treatment alone. Especially in athletes, numerous case reports and series give the recommendation for an early surgical intervention. Comparing the results of the two treatment plans, there is some evidence for a superior outcome after surgical repair with better cosmesis, better functional results, better recovery of muscle power and return to sports compared to the conservative treatment. In summary, anatomic surgical repair is the treatment of choice for complete acute ruptures of the pectoralis major tendon or muscle in athletes. In all other cases, especially in the elderly, conservative treatment remains an important option.