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Rupture of the pectoralis major muscle: Surgical treatment in athletes

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Abstract

Pectoralis major tendon rupture is a relatively rare injury, resulting from violent, eccentric contraction of the muscle. Over 50% of these injuries occur in athletes, classically in weight-lifters during the ‘bench press’ manoeuvre. We present 13 cases of distal rupture of the pectoralis major muscle in athletes. All patients underwent open surgical repair. Magnetic resonance imaging was used to confirm the diagnosis in all patients. The results were analysed using (1) the visual analogue pain score, (2) functional shoulder evaluation and (3) isokinetic strength measurements. At the final follow-up of 23.6 months (14–34 months), the results were excellent in six patients, good in six and one had a poor result. Eleven patients were able to return to their pre-injury level of sports. The mean time for a return to sports was 8.5 months. The intraoperative findings correlated perfectly with the reported MRI scans in 11 patients and with minor differences in 2 patients. We wish to emphasise the importance of accurate clinical diagnosis, appropriate investigations, early surgical repair and an accelerated rehabilitation protocol for the distal rupture of the pectoralis major muscle as this allows complete functional recovery and restoration of full strength of the muscle, which is essential for the active athlete.

Résumé

La rupture du tendon principal du pectoral est un traumatisme rare. Plus de 50% de ces traumatismes surviennent chez des athlètes lors du levé de poids. Nous présentons 13 cas de ces ruptures avec un traitement chirurgical. L’IRM a confirmé le diagnostic chez tous les patients. Les résultats ont été analysés en utilisant une échelle visuelle analogique, une évaluation fonctionnelle de l’épaule et la mesure de la force. Au suivi final de 23,6 mois, les résultats sont excellents pour six patients, bons pour six et mauvais pour un. Onze patients ont retrouvé leur niveau sportif initial. Le temps moyen de reprise du sport était de 8,5 mois. Les constatations opératoires concordaient avec l’aspect IRM chez 11 patients. Nous insistons sur la précision du diagnostic clinique, les examens appropriés, la réparation chirurgicale rapide et la rééducation précoce après la rupture distale du grand pectoral pour permettre une récupération complète, ce qui est essentiel chez les athlètes.

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Author notes

  1. A. Pimpalnerkar

    Present address: , Sanden House, 5, Cressington Drive, Four Oaks Park, Sutton Coldfield, B74 2SU, UK

Authors and Affiliations

  1. Good Hope Hospital, Birmingham, B75 7RR, UK

    R. G. Kakwani, K. M. Kumar & A. Pimpalnerkar

  2. Sports Medicine Centre, 2500 University Drive NW, Calgary, T2N1N4, Canada

    J. J. Matthews & N. Mohtadi

Authors
  1. R. G. Kakwani
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  2. J. J. Matthews
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  3. K. M. Kumar
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  4. A. Pimpalnerkar
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  5. N. Mohtadi
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Correspondence to A. Pimpalnerkar.

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Kakwani, R.G., Matthews, J.J., Kumar, K.M. et al. Rupture of the pectoralis major muscle: Surgical treatment in athletes. International Orthopaedics (SICOT) 31, 159–163 (2007). https://doi.org/10.1007/s00264-006-0171-2

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  • DOI: https://doi.org/10.1007/s00264-006-0171-2

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