Management of Chronic Pectoralis Major Tears using Suture Anchors: Surgical Techniques and Outcomes
Abstract
Introduction: Pectoralis major muscle rupture is one of the most infrequently occurring sports/exercise injuries. Among the various techniques described for its repair, three are most commonly used: transosseous (TOS) through drill hole or bone tunnel, suture anchor (SA), and unicortical or bicortical button (UCB and BCB, respectively).
Materials and methods: In this retrospective observational study, we studied the results of ten cases with complete pectoralis major muscle tears from January 2021 to January 2023. All of them underwent repair using suture anchors in a double-row configuration to get a better anatomical footprint at the insertion site on the humerus, along with box-suture bites through the muscle-tendinous unit to provide a better bulk of muscle available for repair in chronic cases. Functional outcomes were assessed over a one-year follow-up period using the ASES score, Penn score, and Bak’s criteria.
Results: At one-year follow-up, the American Shoulder and Elbow Surgery score (ASES) improved from 46.33±9.83 pre-operative to 97.5±2.73 post-op for acute cases (p – 0.0001), while for chronic cases it went from 52.33±12.31 to 95.77±3.53 (p – 0.0001). According to the ASES score and Bak’s criteria, patients had excellent results with good shoulder ROM without any functional impairment at 12 months post-surgery.
Conclusion: The double row suture anchor technique provides a practical, transosseous equivalent method for repairing pectoralis major ruptures, demonstrating favourable outcomes even in chronic cases. By adapting principles from the familiar rotator cuff repair approach, this technique is particularly relevant in regions where such injuries are infrequently encountered. Nevertheless, the small sample size and lack of objective strength testing in this study highlight the need for further research to validate its efficacy and generalisability.
Abstract | Reference
