Aärimaa Ville, Rantanen Jussi, Heikkilä Jouni, Helttula Ilmo, Orava Sakari
Department of Surgery, Turku University Hospital, Finland.
Am J Sports Med. 2004 Jul-Aug;32(5):1256-62. doi: 10.1177/0363546503261137. Epub 2004 May 18.
Total or near-total rupture of the pectoralis major muscle is a rare injury. Fewer than 200 cases have been reported in literature, many of them in single case reports. There is discrepancy regarding whether this kind of injury should be treated operatively.
Early surgical treatment is necessary to obtain optimal functional recovery following total or near-total ruptures of the pectoralis major muscle.
A case series of 33 operatively treated pectoralis major ruptures combined with a meta-analysis of the previously published cases in the English literature.
The authors have retrospectively analyzed 33 operatively treated cases of total or near-total ruptures of the pectoralis major muscle. They have also analyzed the previously published cases and the final outcomes of their treatment. The difference in outcome between groups of acute operation, delayed operation, and conservative treatment in both their own material and meta-analysis was statistically analyzed.
Both the case series and the analysis of the cases from the literature showed that early operative treatment is associated with better outcome than delayed treatment. The delayed operation was associated with better outcome than the conservative treatment.
Early surgical treatment by anatomic repair gives the best results in the treatment of total and near-total ruptures of the pectoralis major muscle.
胸大肌完全或近乎完全断裂是一种罕见的损伤。文献报道的病例不足200例，其中许多是单例报告。对于这种损伤是否应进行手术治疗存在分歧。
胸大肌完全或近乎完全断裂后，早期手术治疗对于获得最佳功能恢复是必要的。
33例接受手术治疗的胸大肌断裂病例系列，并对英文文献中先前发表的病例进行荟萃分析。
作者回顾性分析了33例接受手术治疗的胸大肌完全或近乎完全断裂病例。他们还分析了先前发表的病例及其治疗的最终结果。对自身资料和荟萃分析中急性手术组、延迟手术组和保守治疗组的结果差异进行了统计学分析。
病例系列和文献病例分析均表明，早期手术治疗比延迟治疗的效果更好。延迟手术比保守治疗的效果更好。
胸大肌完全和近乎完全断裂的治疗中，通过解剖修复进行早期手术治疗效果最佳。
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