CASE REPORTS   

Chirurgia 2016 June;29(3):95-8

Copyright © 2016 EDIZIONI MINERVA MEDICA

language: English

Surgical treatment of a rare case of inveterate pectoralis major rupture: a case report

Matteo VITALI, Nadim NAIM RODRIGUEZ, Alberto PEDRETTI, Andrea SALADINO, Gianfranco FRASCHINI

Department of Orthopedics and Traumatology, San Raffaele Hospital, Milan, Italy

Rupture of the pectoralis major muscle is a rare sports injury most commonly associated with the “bench press” in weight lifting. Injury may also happen due to direct trauma, most notably in rugby players. Our case aims to show how a pectoralis major rupture can be successfully repaired even after a long period of time, 5 years in the case of our patient, has passed between the trauma and the repair. In addition, this is the first described case in the literature of an inveterate rupture of the clavicular head of the pectoralis major. Our patient presented with the rarer clavicular head tear of the pectoralis major muscle. The trauma occurred during the eccentric phase of the “bench press” exercise. Orthopedic evaluations and MRI imaging were used to make the correct diagnosis. The patient underwent myorrhaphy where the upper clavicular head was reattached to the lower sternal head. A brace was prescribed for 5 weeks to keep the arm immobilized. Passive physical rehabilitation was done after the removal of the brace. Following surgical correction and physical rehabilitation, the patient made a successful recovery where he was able to achieve full ROM, was pain-free and had satisfactory esthetics. This paper aims to point out the rarity of the case in regards to the area of rupture, the clavicular head, and in particular the time interval between injury and treatment (5 years), making it, to our knowledge, the first described case of inveterate rupture of the clavicular head of the pectoralis major.