Pectoralis Major Repair
Problem
- The pec major muscle avulses from its insertion on the Humerus (arm) bone.
Cause
- Usually results from a sudden strain to the muscle as the upper arm is forced backwards eg. Heavy lifting, tackle situation.
Diagnosis
- Pain is felt in the front of the shoulder
- With “hands on hips” there is an obvious asymmetry between the shape of the axilla.
- X-rays are usually normal.
- An MRI or Ultrasound can help confirm the diagnosis.
Treatment
- Surgical, General Anaesthetic
- Day Stay surgery or overnight stay.
- The muscle needs to be reattached to the humerus.
- This can usually be achieved with a row of suture anchors that tap into the bone and secure the muscle tendon back to its insertion.
- Occasionally in chronic tears, a hamstring graft is required to bridge the gap.
Potential Complications
- Infection, haematoma, neurovascular injury
- Stiffness to shoulder
- Rerupture of repair.
Post-Operative Care
- Patient to remain in polysling for six weeks
- Come out of sling for elbow extension and gentle pendulum exercises.
- External rotation to neutral.
- From six weeks to three months.
- Out of sling; work at gradually increasing external rotation
- From three months
- Start strengthening exercises.
