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Rupture of the pectoralis major muscle

Allen B. Richardson, MD

Nineteen cases of rupture of the pectoralis major mus cle are presented. ln 16 cases the rupture was repaired; in 3 cases repair was not performed. Physical findings and surgical technique are described and the anatomy of the insertion of the pectoralis major muscle is re viewed. Nine of the patients in this series sustained their injury while performing the bench press. The ma jority of the remaining patients were also involved in sports when injury occurred. Eleven of the ruptures were in the nondominant arm and eight in the dominant arm. All of the patients complained of weakness, pain, and deformity, with weakness being the major com plaint.

Following surgery and rehabilitation, all 16 patients who underwent repair were relieved of pain. The de formity was corrected in all 16 patients, although 2 patients who had a 5 year interval from repair to rupture did not achieve a completely normal contour. Thirteen of the 16 patients reported a full return to strength. The others had significant improvements.

Ruptures of the pectoralis major muscle are uncom mon, but not rare. Ruptures occurring under tension tear at or near the insertion onto the humerus, as in all 19 cases in this series. Distal ruptures are usually complete, despite physical signs that may be mislead ing. Distal tears are reparable, even after a delay to treatment. After surgical repair, the majority of patients may expect relief of pain, return of strength and normal contour, and maintenance of range of motion.

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