Pectoralis Major Muscle Rupture in Athletes: A Prospective Study

Authors: Alberto de Castro Pochini, Benno Ejnisman, Carlos Vicente Andreoli, Gustavo Cara Monteiro, Antonio Carlos Silva, Moises Cohen, and Walter Manna Albertoni

References: Am J Sports Med 2010;38 92-98

 Background In the past 20 years, there has been an increase in the incidence of upper extremity tendinous injuries, especially in sports including strong physical activity, such as in weight lifting, as well as with the concurrent use of anabolic steroids. Today, there are more than 200 cases describing rupture of the pectoralis major muscle in athletes.

Hypothesis Surgical treatment will have a better outcome than nonsurgical treatment in total rupture of the pectoralis major muscle in athletes.

Study Design Cohort study; Level of evidence, 2.

Methods Twenty athletes with pectoralis major muscle (PMM) rupture were studied; 10 had surgical treatment, and the other 10 were treated nonoperatively. The mean age was 32.27 years (range, 27-47 years); all of them were men. The average follow-up was 36 months (range, 48-72 months). Injuries were diagnosed by history, physical examination, and subsidiary tests. Functional evaluation and isokinetic evaluation were performed on all 20 patients.

Results The clinical evaluation revealed 70% (n = 7) excellent, 20% good (n = 2), and 10% poor (n = 1) outcomes for the cases treated with surgery and 20% good (n = 2), 50% fair (n = 5), and 40% poor (n = 4) outcomes for the cases treated nonsurgically. The isokinetic evaluation at 60-deg/s speed showed a decrease in strength of 53.8% in the nonsurgical group and 13.7% for the surgical group.

Conclusion Total PMM rupture in athletes showed a better functional result after surgical treatment than after nonsurgical treatment. 

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