Mobilization Techniques for Acute and Chronic Retracted Pectoralis Major Tears for Primary Repair

Pectoralis major (PM) tears are uncommon yet increasing in incidence in the athletic population. Previous research has favored operative management of both acute and chronic PM tears. Primary repair is indicated for both acute and chronic tears, when possible, to improve functional outcomes and cosmesis. Often, lack of viable tissue and inadequate tendon length make primary repair challenging, especially with increased chronicity and increased retraction. Autograft and allograft tendon use is described to bridge a residual gap between tendinous tissue and the footprint or to augment tissue quality. However, to our knowledge, the literature is scarce regarding detailed technical tips and tricks on how to specifically mobilize a chronically torn and/or markedly retracted PM. This article clearly describes and depicts the step-by-step approach and surgical technique for mobilizing a markedly retracted and/or chronically torn PM. It also describes and shows how to use and position an allograft patch if needed.