Pectoralis major Rupture. A Prospective Study
Authors: Alberto De Castro Pochini, Benno Ejnisman, Carlos Vicente Andreoli, Gustavo Cara Monteiro, Walter Manna Albertoni, Moises Cohen
References: Presented at ICSES 2010
In the past 20 years, there was an increase on 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 described rupture of pectoralis major in athletes. What the better treatment?Conservative or Surgical.
Hypothesis: Surgical treatment has a better outcome than non surgical in total rupture of pectoralis major in athletes. Study design: Cohort study. Objective: To present a prospective comparative study of 20 athletes showing pectoralis major muscle PMM rupture, comparing surgical and non-surgical treatment using clinical and functional (isokinetic evaluation) criteria for evaluation.
Materials and methods: Twenty athletes with PMM rupture have been studied. The mean age was 32.27 years old (ranging from 27 to 47 years old), all of them were males. The average follow-up was 56 months (ranging from 48 to 72months). Injuries were diagnosed by history, physical examination and subsidiary tests. Functional evaluation suggested by Bak et al and isokinetic evaluation were performed in all 20 patients. Ten cases were treated with surgery and ten were treated non-surgically.
Results: The clinical evaluation revealed 70% (seven cases) of excellent outcomes, 20% (two cases) good, and 10% (one case) poor for the cases submitted to surgery; and, 20% (two cases) good, 50% (five cases) fair, and 40% (four cases) poor outcomes for the cases treated in a non-surgical way. The isokinetic evaluation at 60 degrees/s speed showed decrease of 41,2% in the nonsurgical group and 13.7% for the surgical group.
Conclusion: Total PMM rupture in athletes showed a better functional result with surgical treatment when compared to conservative treatment in 20 patient studied.