Pectoralis Major Tears

Epidemiology

 

Middle age men

Steroids / Growth Hormone

 

Aetiology

 

Usually occurs in gym

Bench Press

 

Clinical

 

Significant bruising in the acute phase

 

In chronic setting, ask patient to adduct against hip / resistance

 

Pectoralis Major TearPectoralis Tear 2

 

Usually complain of weakness, mainly in gym

 

MRI

 

MRI Pectoralis Major TearPectoralis Tear MRI

 

Management

 

Non operative

 

Good results

Will have cosmetic deformity

Weakness usually only in the gym with bench press

 

Operative

 

Indications

- acute tears in young patients

- cosmesis i.e. body builders

 

Acute repair

 

Pect Major Repair Through Bone TroughIncision Pec Major Repair

 

Technique

- deltopectoral approach / can alos make in skin crease

- find tendons medially

- drill one inche trough in humerus

- place sutures in tendon

- pass sutures through drill holes lateral to trough

- pull tendon into trough and tie sutures

 

Chronic Reconstruction

 

Technique

- tendoachilles graft

- pass through muscle in pul ve taft method

- tie down into bone trough in humerus

 

Pect Major Reconstruction 1Pec Major Reconstruction 2Pec Major Reconstruction 3