Open Pectoralis Major Repair: Endobutton Fixation.

Area of Science:

• Orthopedic Surgery
• Sports Medicine
• Surgical Techniques

Background:

• Pectoralis major ruptures commonly result from eccentric contractions.
• Surgical repair options for acute tears include direct repair, suture anchors, and endobutton fixation.
• This video demonstrates repair using a unicortical endobutton fixation construct.

Purpose of the Study:

• To detail a surgical technique for acute pectoralis major tendon ruptures.
• To present unicortical endobutton fixation as a viable surgical option.
• To highlight indications and outcomes for this specific repair method.

Main Methods:

• The technique involves a beach-chair position and deltopectoral approach.
• The torn pectoralis major sternal head is mobilized and repaired using SutureTape in a Krackow fashion.
• Unicortical endobuttons are placed for fixation, with a corticectomy created for each button.

Main Results:

• A systematic review showed 83% of patients achieved good or excellent outcomes with endocortical button fixation.
• Studies indicate no significant difference in functional outcomes or complication rates compared to other fixation methods.
• Unicortical endobutton fixation demonstrates comparable efficacy to alternative repair strategies.

Conclusions:

• Unicortical endobutton fixation is a suitable surgical strategy for acute pectoralis major tears.
• This technique is particularly beneficial for young, active, high-demand individuals.
• The described method provides an effective fixation option for pectoralis major tendon ruptures.