Rupture of Pectoralis Major Muscle: A Case Report

Pectoralis major (PM) muscle ruptures are uncommon injuries. 365 cases of PM injury have been reported, with 75% occurring in the past 20 years; of these, 83% were a result of indirect trauma, with 48% occurring during weight-training activities. We report a case of PM rupture in a 35-year-old gym trainer who presented to our hospital with pain and weakness in his right shoulder after injury while doing bench press treated with Primary repair using Ethibond 5-0 and endobuttons who had excellent function outcome and no evidence of complication at 2 years follow-up.

A 35-year-old gentleman presented to the emergency department after experiencing sudden pain in his right chest and a tearing sensation while bench pressing (approximately 100 kg). He is a gym trainer who exercised with a lot of weight and denied any steroid use. Upon clinical examination, he had ecchymosis and loss of shoulder contour, bulking over the right chest. The shoulder range of movement was preserved, with weakness of adduction and internal rotation. Plain radiographs of the right shoulder were obtained which was normal. A magnetic resonance imaging (MRI) scan revealed a PM rupture at the insertion site with retraction and the patient was treated with primary repair of the PM. The patient exhibited satisfactory shoulder range of movement by 3 months follow-up and achieved his pre-injury strength by 6 months follow-up.

PM ruptures are uncommon injuries that commonly occur in young men between 20 and 40 years old. Patients usually present with shoulder pain and weakness after a strenuous activity and a diagnosis can be made with MRI. Hence, surgical treatment should be offered to all young patients with PM tear irrespective of level of activity and conservative management should be reserved for geriatric patients with low activity levels and medically unfit patients.