Pectoralis Major Rupture: Evaluation and Management

Area of Science:

• Orthopedic Surgery
• Sports Medicine
• Musculoskeletal Injuries

Background:

• Pectoralis major tendon ruptures are increasingly common, particularly in young, active males.
• The injury typically occurs during eccentric muscle contraction, often associated with bench pressing.
• Accurate diagnosis relies heavily on thorough physical examination, comparing findings to the contralateral side.

Purpose of the Study:

• To review the diagnosis and treatment of pectoralis major tendon ruptures.
• To compare outcomes of surgical versus non-surgical management for acute and chronic injuries.
• To highlight challenges and potential complications associated with surgical repair.

Main Methods:

• Review of current literature on pectoralis major tendon ruptures.
• Emphasis on diagnostic physical examination findings (e.g., swelling, ecchymosis, loss of anterior axillary fold, decreased pectoralis major index).
• Discussion of surgical techniques for acute and chronic tear repair, including reconstruction options.

Main Results:

• Surgical treatment of acute pectoralis major tendon ruptures demonstrates superior functional outcomes and return to activity rates compared to non-surgical management.
• Chronic tear repair is technically demanding and may necessitate grafts (autograft or allograft).
• Potential complications include rerupture, persistent pain, and infection, even with advanced surgical techniques.

Conclusions:

• Prompt diagnosis through physical examination is crucial for effective management of pectoralis major tendon ruptures.
• Surgical intervention is the preferred treatment for acute injuries, yielding better functional results.
• Management of chronic tears requires specialized approaches, and vigilance for complications is necessary post-surgery.