Clinics in Shoulder and Elbow

Korean Shoulder and Elbow Society (대한견·주관절의학회)
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A review of chronic pectoralis major tears: what options are available?

  • Joshua R. Giordano (Zucker School of Medicine at Hofstra/Northwell) ;
  • Brandon Klein (Zucker School of Medicine at Hofstra/Northwell) ;
  • Benjamin Hershfeld (New York Institute of Technology College of Osteopathic Medicine) ;
  • Joshua Gruber (Nova Southeastern University College of Osteopathic Medicine) ;
  • Robert Trasolini (Zucker School of Medicine at Hofstra/Northwell) ;
  • Randy M. Cohn (Zucker School of Medicine at Hofstra/Northwell)
  • Received : 2023.01.31
  • Accepted : 2023.03.21
  • Published : 2023.09.01
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Abstract

Rupture of the pectoralis major muscle typically occurs in the young, active male. Acute management of these injuries is recommended; however, what if the patient presents with a chronic tear of the pectoralis major? Physical exams and magnetic resonance imaging can help identify the injury and guide the physician with a plan for management. Nonoperative management is feasible, but is recommended for elderly, low-demand patients whose functional goals are minimal. Repair of chronic tears should be reserved for younger, healthier patients with high functional demands. Although operative management provides better functional outcomes, operative treatment of chronic pectoralis tears can be challenging. Tendon retraction, poor tendinous substance and quality of tissue, muscle atrophy, scar formation, and altered anatomy make direct repairs complicated, often necessitating auto- or allograft use. We review the various graft options and fixation methods that can be used when treating patients with chronic pectoralis major tears.

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References

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