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Surgery is effective for treating pectoralis major tendon ruptures

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A retrospective review of 134 patients has shown that surgery is an effective and safe option to treat pectoralis major tendon (PMT) ruptures.

After examining 134 cases of acute and chronic traumatic PMT rupture which were repaired surgically, researchers concluded that surgical repair of this injury can be performed safely, with a low re-rupture rate and low risk of complications.

Surgical repair techniques included suture anchors, sutures through bone tunnels, suture button, end-to-end suture repair, and a biotenodesis screw.

Of 120 patients who reached final follow-up, 17 (13%) suffered from a complication. The suture end-to-end repair represented the highest percentage (18%) of complications of all surgical approaches.

Using a suture button had the lowest complication rate, and in general the results suggested that use of an implant may minimise complications.

“When ‘implant’ versus ‘no implant’ was evaluated, we found that use of an implant was associated with a lower re-tear rate, a lower rate of fracture and a lower rate of post operative stiffness,” the researchers explained.

“At final follow-up with patients at an average of 71 days post-operation, 114 of 120 (95%) were able to return to their occupation at full capacity,” said corresponding author Michelle T. Sugi, MD, MPH, from the Keck School of Medicine at the University of Southern California. “We also only identified three instances of failed repair, which is notable for a study group of this size.”

The most common cause of injury was weight lifting (62%), followed by trauma (18%) and martial arts (9%).

Until now, the research on treating PMT ruptures was limited to several small case series, the largest containing 24 cases, and systematic reviews.

“We hope our research can contribute to a better understanding of who is affected by these injuries, how to treat them, and how to address potential complications,” Dr Sugi said.

Further prospective studies are needed to determine the best surgical repair technique, the researchers noted.

The findings were presented at last week’s annual meeting of the American Orthopaedic Society for Sports Medicine in Toronto, Canada.