Komurcu Mahmut, Yildiz Yavuz, Ozdemir M Taner, Erler Kaan
Department of Orthopedics, Gulhane Military Medical Academy, Ankara, Turkey.
Aviat Space Environ Med. 2004 Jan;75(1):81-4.
Rupture of the pectoralis major muscle is a very rare injury. Excessive contraction of muscle fibers during certain forms of sports, such as weightlifting and bench pressing, is the most common cause. Among the 150 reported cases in the literature, in only 1 case did the injury happen during the landing phase of parachuting. Here we report a case of pectoralis major muscle rupture caused by a different mechanism than published previously. A paratrooper was injured during a tactical jump out of an aircraft after becoming entangled with the risers. The mechanism of injury was excessive traction and malpositioning of his shoulder when the parachute deployed. A three-phase conservative treatment regimen was performed and results were assessed by dynamometry. The patient was satisfied with the treatment and the dynamometric results were good at 9 mo after injury and at the end of a 20-mo follow-up period. We suggest that three-phase rehabilitation can be an effective treatment option for pectoralis major muscle rupture in selected patients. Prevention of this type of altitude injury would be possible by applying the fundamentals of parachuting.
胸大肌断裂是一种非常罕见的损伤。在某些形式的运动中,如举重和卧推,肌肉纤维过度收缩是最常见的原因。在文献报道的150例病例中,只有1例损伤发生在跳伞着陆阶段。在此,我们报告一例胸大肌断裂,其损伤机制与先前发表的不同。一名伞兵在战术跳伞时与伞绳缠绕后受伤。损伤机制是降落伞展开时肩部受到过度牵引和位置不当。实施了一个三阶段的保守治疗方案,并通过肌力测试评估结果。患者对治疗满意,受伤9个月时以及20个月随访期结束时肌力测试结果良好。我们建议,三阶段康复对于部分胸大肌断裂患者可能是一种有效的治疗选择。通过应用跳伞的基本原理可以预防这类高空损伤。