Pectoralis Major Repair

What is a Pectoralis Major Repair?

Pectoralis major repair is surgery to repair the tendon of a large muscle in the chest called the pectoralis major. This muscle is used when you pull your shoulder across your chest. The pectoralis major originates from the clavicle (collar bone) as well as the sternum (breastbone) and is attached near the top of the upper arm bone (humerus).

How is the Pectoralis Major Injured?

The pectoralis major may be injured while weightlifting, bench pressing or other activities where the arm is forced into external rotation while being contracted. This may cause a partial or complete tear of the pectoralis major within the tendon, muscle or at their junction. You may hear a pop in your chest or shoulder which may be accompanied by pain and bruising in the front of your shoulder and arm weakness.

Treatment of Pectoralis Major Injuries

Partial tears of the pectoralis major may be treated conservatively with rest, a sling, ice application, compression and medications. Physical therapy may be recommended 2 weeks after the injury. Tears at the junction of the muscle and tendon respond better to conservative treatment. Pectoralis major repair surgery is performed for severe or complete tears of the pectoralis major.

What are the Benefits of Pectoralis Major Repair Surgery?

Pectoralis major repair surgery is associated with:

  • Better pain reduction
  • Better restoration of strength in the injured arm
  • Return to more strenuous activities

Procedure for Pectoralis Major Repair

Pectoralis major repair may be performed as an inpatient or outpatient procedure. During the procedure, the torn muscle or tendon ends are identified and sutured together. Suture anchors are used to reattach the tendon to the bone. The earlier the operation is performed, the better the outcome as this minimises the possibility of tendon retraction. If surgery is performed after 3 months, retraction is significant and tendon grafting may be necessary. In cases of retraction, a donor tendon may be used to reconstruct the pectoralis major.

Recovery After Pectoralis Major Repair Surgery

When you awake from the procedure, your arm and shoulder will be in a sling. You will then go to the recovery room. You may be able to leave the hospital the same day or after a short stay. Pain and swelling at the site can be controlled by application of ice, a nerve block injection or IV medication. You will later switch to oral pain medicines.

After the first day of surgery you are instructed to remove the sling to perform mobility exercises and should then place the sling back on.

The wound should be kept dry for at least 2 weeks after surgery although you may be allowed to shower within 2 days of the procedure. You will usually return to the clinic in 10-14 days for a follow-up.

When Can I Expect to Return to Activities/Work after a Pectoralis Major Repair?

This depends on the extent of the injury. It may take about six weeks to return to strenuous activities. You can return sooner to your regular duties.

What are the Risks Associated with Pectoralis Major Repair Surgery?

Risks associated with pectoralis major repair include:

  • Pain
  • Infection
  • Fracture of the humerus or glenoid bones
  • Repeat rupture
  • Problems with anaesthesia
  • Bleeding, hematoma or clot formation
  • American Academy of orthopedic Surgeon
  • Anthroscopy Association of North America
  • American Orthopedic Society of Sports Medicine
  • American Shoulder and Elbow Society
  • Association of Graduates
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