Backround
M. pectoralis major ruptures are not very common. Surgical therapy is currently critically discussed. Which results are achieved by surgical therapy and which factors influence the results?
Patients and methods
A total of 91 patients treated for 105 pectoralis major ruptures were prospectively recorded. All except 4 patients were male bodybuilders who named bench pressing as the cause of the injury in 81 cases. The tendon was affected 17 times, the musculotendinous junction 77 times, and the muscle 11 times. The pars sternalis itself was affected 20 times, 67 times in combination with the pars abdominalis and nine times in combination with the pars clavicularis. The pars abdominalis was solely affected six times. Complete ruptures over all three sections were diagnosed in only three cases. Surgical reconstruction was performed in 64 cases. A total of 27 acute reconstructions, 10 post acute and 27 secondary reconstructions were performed.
Results
All athletes showed unrestricted mobility and function of the shoulder at follow-up. All primarily and post primarily operated patients showed good and very good results. In the case of chronic ruptures, only 7 of 27 cases led to poor results. Conservative treatment showed only in partial muscular ruptures acceptable results.
Conclusion
Accurate diagnosis and early surgical anatomical reconstruction of the pectoralis major rupture showed better results than nonsurgical treatment or delayed operative treatment.