Rupture of the pectoralis major muscle

Background: Total or near-total rupture of the pectoralis major muscle is a rare injury. Fewer than 200 cases have been reported in literature, many of them in single case reports. There is discrepancy regarding whether this kind of injury should be treated operatively.

Hypothesis: Early surgical treatment is necessary to obtain optimal functional recovery following total or near-total ruptures of the pectoralis major muscle.

Study design: A case series of 33 operatively treated pectoralis major ruptures combined with a meta-analysis of the previously published cases in the English literature.

Methods: The authors have retrospectively analyzed 33 operatively treated cases of total or near-total ruptures of the pectoralis major muscle. They have also analyzed the previously published cases and the final outcomes of their treatment. The difference in outcome between groups of acute operation, delayed operation, and conservative treatment in both their own material and meta-analysis was statistically analyzed.

Results: Both the case series and the analysis of the cases from the literature showed that early operative treatment is associated with better outcome than delayed treatment. The delayed operation was associated with better outcome than the conservative treatment.

Conclusion: Early surgical treatment by anatomic repair gives the best results in the treatment of total and near-total ruptures of the pectoralis major muscle.