Introduction

Pectoralis major tear is not a common but functionally important injury and there is an increase in cases of pectoralis major injury as shown by recent literature. Reasons for the increase in cases are due to interest in intense sports activities, weightlifting particularly bench pressing and in military personnel. Moreover, the use of anabolic steroids especially in weightlifters also has an association with a tear of the tendon. Males from 20 to 40 years of age are more prone to this injury.

Methods

We are presenting a retrospective review of prospectively collected data on patients who had pectoralis major tear repairs from January 2020 to January 2024, ensuring a minimum follow-up of one year.

Exclusion criteria included revision PMT repair, reconstruction, and concomitant repair of another glenohumeral tendon/ligament. All patients were assessed a minimum of 1 year postoperatively for clinical outcomes, Return to sports and Cosmetic satisfaction and strength satisfaction physical exam, ROM & cosmesis using Bak Criteria.

Results

All patients were men with an average age of 30 years at the time of injury. The average time from injury to surgical repair was 31 days and the average follow-up was 12 months. Most patients suffered an injury while bench pressing (15/22; 60%) or wrestling (3/20; 15%). The most common intra-operative findings were partial sternal tears (7/22; 31%) followed by complete sternal tears (15/22; 69%). According to the Bak criteria, overall results were excellent in 11 patients (50%), good in 9 (37%), while 3 patients (13%) had a fair result. Cosmetic satisfaction was achieved in 20 out of 22 patients. Seventeen patients returned to sports, averaging 18 weeks (range 7-32 weeks), and return to work averaged 9 weeks (range 5-22 weeks). Outcomes were satisfactory for 18 patients and fair for 4, with no reported steroid use or complications.

Conclusions

Pectoralis major tear repair produces improved PROs at final follow-up compared to preoperative values.

Key Words: Pectoralis Major, Tear, Repair, Outcome, Work, Sports

Level of Evidence: Level 4