Chronic Rupture of Pectoralis Major Muscle Repair: A Surgical Case Report

INTRODUCTION: Pectoralis major injury is a rare injury. Its incidence increases with sports related activities. Early diagnosis is essential to obtain a satisfactory functional outcome. We present in this paper a case of 39-year-old male patient presenting with missed chronic the right pectoralis major muscle injury treated with anatomic surgical reinsertion of the muscle tendon to the humerus. CASE REPORT: A 39-year-old male bodybuilder patient felt a snap in his right dominant shoulder while performing bench press. Diagnosis was missed by two physicians and right shoulder MRI confirmed the diagnosis of pectoralis major muscle injury. Reinsertion of the PM muscle tendon using suture anchor was done through deltopectoral approach. Shoulder immobilization for 1 month followed by passive and active range of motion exercises results in satisfactory cosmetic and functional outcome. CONCLUSION: PM muscle rupture affects mainly young male weightlifters. Loss of the anterior axillary fold is pathognomonic for PM injury. Magnetic resonance imaging of the chest wall is the gold standard examination for the diagnosis. Acute surgical repair (<6 weeks) is recommended to obtain good or excellent cosmetic and functional outcomes. Reconstruction showed lower strength and patient satisfaction; however, results were still significantly better than non-operative treatment reserved for patients with partial tears, muscle belly irreparable damage, and elderly patients with medical comorbidities whom operative treatment is not indicated.