Current Treatment Options for Complete Ruptures of the Pectoralis Major Tendon

Orthopädische Klinik, Universitätsklinikum Düsseldorf.
Sportverletzung · Sportschaden (Impact Factor: 0.33). 09/2011; 25(3):147-52. DOI: 10.1055/s-0031-1273369
Source: PubMed


The rupture of the pectoralis major tendon is an uncommon pathological condition that is reported in literature to prevail among athletes, although also case reports and case series of nursing home residents or workers can be found, as well as traumatic lesions. Among athletes, pectoralis major tendon ruptures have shown a significant increase in incidence over the last years. This may be due to the higher number of individuals taking part in high-impact sports and weight-lifting. In the recent literature, there are only few recommendations to rely on conservative treatment alone. Especially in athletes, numerous case reports and series give the recommendation for an early surgical intervention. Comparing the results of the two treatment plans, there is some evidence for a superior outcome after surgical repair with better cosmesis, better functional results, better recovery of muscle power and return to sports compared to the conservative treatment. In summary, anatomic surgical repair is the treatment of choice for complete acute ruptures of the pectoralis major tendon or muscle in athletes. In all other cases, especially in the elderly, conservative treatment remains an important option.

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    ABSTRACT: Background: Injuries to the pectoral is major muscle can result in functional limitation. Previous reports on conservative treatment on large tears of the pectoral is major muscle showed inconsistent results with several treatment modalities. The best option to treat this pathology is still under discussion. Methods: A 30 year-old male patient with a large pectoral is major muscle tear was treated with ultrasound- guided EPI® technique once a week and eccentric exercise. Echography study was performed during the follow-up. Functional evaluation was assessed with Tegner scale, the criteria described by Bak et al. and the subjective outcomes described by Anthony et al. Results: Ultrasound scan showed a correct arrangement of muscle fibers. Functional evaluation showed excellent results and at four weeks of treatment, the patient had returned to their level of activity prior to the injury. Conclusion: Treatment with the US-guided EPI® technique on pectoral is major muscle tear resulted in a high improvement in function and a rapid return to the previous level of activity after few sessions. The procedure has proven to be safe with no recurrences at one-year follow-up.