Sports Medicine

, Volume 32, Issue 14, pp 945–952 | Cite as

Injuries to the Pectoralis Major

Injury Clinic

Abstract

Pectoralis major injuries typically occur in active individuals participating in manual labour or sports. While these injuries are rarely reported, the actual incidence of pectoralis tears among all shoulder injuries is unknown. Diagnosis can usually be made based on a patient’s history and physical examination. However, ultrasound and magnetic resonance imaging are helpful tools for diagnosis and pre-operative planning. Specific treatment options should be based on the severity of the injury and the patient’s individual needs. Nonoperative management consisting of immobilisation and physical therapy can offer a functional result with return of shoulder motion and activities of daily living. In recent studies, operative repair of pectoralis major rupture has been shown to restore normal chest-wall muscle contours and pre-operative strength (even in competitive athletes). Although complications such as re-rupture, infection, and heterotopic ossification do occasionally occur, favourable results should be expected when surgical repair is performed either acutely or in a delayed fashion.

References

  1. 1.
    McEntire JE, Hess WE, Coleman SS. Rupture of the pectoralis major muscle: a report of eleven injuries and review of fiftysix. J Bone Joint Surg Am 1972 Jul; 54 (5): 1040–6PubMedGoogle Scholar
  2. 2.
    Goriganti MR, Bodack MP, Nagler W. Pectoralis major rupture during gait training: case report. Arch Phys Med Rehabil 1999 Jan; 80 (1): 115–7PubMedCrossRefGoogle Scholar
  3. 3.
    Beloosesky Y, Hendel D, Weiss A, et al. Rupture of the pectoralis major muscle in nursing home residents. Am J Med 2001 Aug 15; 111 (3): 233–5PubMedCrossRefGoogle Scholar
  4. 4.
    Delport HP, Piper MS. Pectoralis major rupture in athletes. Arch Orthop Trauma Surg 1982; 100 (2): 135–7PubMedCrossRefGoogle Scholar
  5. 5.
    Bak K, Cameron EA, Henderson IJ. Rupture of the pectoralis major: a meta-analysis of 112 cases. Knee Surg Sports Traumatol Arthrosc 2000; 8 (2): 113–9PubMedCrossRefGoogle Scholar
  6. 6.
    Schepsis AA, Grafe MW, Jones HP, et al. Rupture of the pectoralis major muscle: outcome after repair of acute and chronic injuries. Am J Sports Med 2000 Jan-Feb; 28 (1): 9–15PubMedGoogle Scholar
  7. 7.
    Kretzler Jr HH, Richardson AB. Rupture of the pectoralis major muscle. Am J Sports Med 1989 Jul-Aug; 17 (4): 453–8PubMedCrossRefGoogle Scholar
  8. 8.
    Wolfe SW, Wickiewicz TL, Cavanaugh JT. Ruptures of the pectoralis major muscle: an anatomic and clinical analysis. Am J Sports Med 1992 Sep-Oct; 20 (5): 587–93PubMedCrossRefGoogle Scholar
  9. 9.
    Dunkelman NR, Collier F, Rook JL, et al. Pectoralis major muscle rupture in windsurfing. Arch Phys Med Rehabil 1994 Jul; 75 (7): 819–21PubMedGoogle Scholar
  10. 10.
    Jones MW, Matthews JP. Rupture of pectoralis major in weight lifters: a case report and review of the literature. Injury 1988 May; 19 (3): 219PubMedCrossRefGoogle Scholar
  11. 11.
    Kersch TJ, Cirillo RM, Fay MJ. Pectoralis major tendon rupture in a water skier: case report. Contemp Orthop 1992; 24: 437–41Google Scholar
  12. 12.
    Rijnberg WJ, van Linge B. Rupture of the pectoralis major muscle in body-builders. Arch Orthop Trauma Surg 1993; 112 (2): 104–5PubMedCrossRefGoogle Scholar
  13. 13.
    Moore KL. Clinically oriented anatomy. 3rd ed. Baltimore (MD): Williams & Wilkins, 1992Google Scholar
  14. 14.
    Curtis Jr RJ. Injuries of the proximal humerus region. In: DeLee JC, Drez Jr D, editors. Orthopaedic sports medicine: principles and practice. Philadelphia (PA): W.B. Saunders, 1994: 705–9Google Scholar
  15. 15.
    Manktelow RT, McKee NH, Vettese T. An anatomical study of the pectoralis major muscle as related to functioning free muscle transplantation. Plast Reconstr Surg 1980 May; 65 (5): 610–5PubMedCrossRefGoogle Scholar
  16. 16.
    Sunderland S. Nerve and nerve injuries. 2nd ed. Edinburgh: Churchill Livingstone, 1978: 860–2Google Scholar
  17. 17.
    Aszmann OC, Rab M, Kamolz L, et al. The anatomy of the pectoral nerves and their significance in brachial plexus reconstruction. J Hand Surg [Am] 2000 Sep; 25 (5): 942–7CrossRefGoogle Scholar
  18. 18.
    Kono M, Johnson EE. Pectoralis major tendon avulsion in association with a proximal humerus fracture. J Orthop Trauma 1996; 10 (7): 508–10PubMedCrossRefGoogle Scholar
  19. 19.
    Tietjen R. Closed injuries to the pectoralis major muscle. J Trauma 1980; 20: 262–4PubMedCrossRefGoogle Scholar
  20. 20.
    Anbari A, Kelly IV JD, Moyer RA. Delayed repair of a ruptured pectoralis major muscle: a case report. Am J Sports Med 2000 Mar-Apr; 28 (2): 254–6PubMedGoogle Scholar
  21. 21.
    Liu J, Wu JJ, Chang CY, et al. Avulsion of the pectoralis major tendon. Am J Sports Med 1992 May-Jun; 20 (3): 366–8PubMedCrossRefGoogle Scholar
  22. 22.
    Roi GS, Respizzi S, Dworzak F. Partial rupture of the pectoralis major muscle in athletes. Int J Sports Med 1990 Feb; 11 (1): 85–7PubMedCrossRefGoogle Scholar
  23. 23.
    Scott BW, Wallace WA, Barton MA. Diagnosis and assessment of pectoralis major rupture by dynamometry. J Bone Joint Surg Br 1992 Jan; 74 (1): 111–3PubMedGoogle Scholar
  24. 24.
    Arciero RA, Cruser DL. Pectoralis major rupture with simultaneous anterior dislocation of the shoulder. J Shoulder Elbow Surg 1997 May-Jun; 6 (3): 318–20PubMedCrossRefGoogle Scholar
  25. 25.
    Simonian PT, Morris ME. Pectoralis tendon avulsion in the skeletally immature. Am J Orthop 1996 Aug; 25 (8): 563–4PubMedGoogle Scholar
  26. 26.
    Verfaillie SM, Claes T. Bony avulsion of the pectoralis major muscle. J Shoulder Elbow Surg 1996 Jul-Aug; 5 (4): 327–9PubMedCrossRefGoogle Scholar
  27. 27.
    Chapple K, Kelty C, Irwin LR, et al. Traumatic abscess of pectoralis major. Arch Orthop Trauma Surg 2000; 120 (7–8): 479–81PubMedGoogle Scholar
  28. 28.
    Connell DA, Potter HG, Sherman MF, et al. Injuries of the pectoralis major muscle: evaluation with MR imaging. Radiology 1999 Mar; 210 (3): 785–91PubMedGoogle Scholar
  29. 29.
    Lee J, Brookenthal KR, Ramsey ML, et al. MR imaging assessment of the pectoralis major myotendinous unit: an MR imaging-anatomic correlative study with surgical correlation. AJR Am J Roentgenol 2000 May; 174 (5): 1371–5PubMedGoogle Scholar
  30. 30.
    Miller MD, Johnson DL, Fu FH,et al. Rupture of the pectoralis major muscle in a collegiate football player: use of magnetic resonance imaging in early diagnosis. Am J Sports Med 1993 May-Jun; 21 (3): 475–7PubMedCrossRefGoogle Scholar
  31. 31.
    Ohashi K, El-Khoury GY, Albright JP, et al. MRI of complete rupture of the pectoralis major muscle. Skeletal Radiol 1996 Oct; 25 (7): 625–8PubMedCrossRefGoogle Scholar
  32. 32.
    Alho A. Ruptured pectoralis major tendon: a case report on delayed repair with muscle advancement. Acta Orthop Scand 1994 Dec; 65 (6): 652–3PubMedCrossRefGoogle Scholar
  33. 33.
    Hanna CM, Glenny AB, Stanley SN, et al. Pectoralis major tears: comparison of surgical and conservative treatment. Br J Sports Med 2001 Jun; 35 (3): 202–6PubMedCrossRefGoogle Scholar
  34. 34.
    Pai VS, Simison AJ. A rare complication of pectoralis major rupture. Aust N Z J Surg 1995 Sep; 65 (9): 694–5PubMedCrossRefGoogle Scholar
  35. 35.
    Purnell R. Rupture of the pectoralis major muscle: a complication. Injury 1988 Jul; 19 (4): 284PubMedCrossRefGoogle Scholar
  36. 36.
    Smith FC. Rupture of the pectoralis major muscle: a caveat. Injury 1988 Jul; 19 (4): 282–3PubMedCrossRefGoogle Scholar

Copyright information

© Adis International Limited 2002

Authors and Affiliations

  1. 1.Department of Orthopaedics and RehabilitationYale University School of MedicineNew HavenUSA
  2. 2.Weill-Cornell Medical CollegeHospital for Special SurgeryNew YorkUSA

Personalised recommendations