Belk John W, Bravman Jonathan T, Frank Rachel M, Seidl Adam J, McCarty Eric C
University of Colorado, Aurora, Colorado, USA.
Video J Sports Med. 2023 Jan 10;3(1):26350254221131058. doi: 10.1177/26350254221131058. eCollection 2023 Jan-Feb.
Pectoralis major ruptures are rare injuries that occur in young men between 20 and 40 years of age, typically during resistance training in the eccentric phase of muscle contraction. As the incidence of these ruptures increases with increasing activity levels and use of anabolic steroids, it is important to understand effective repair techniques.
Repair of the ruptured pectoralis major tendon is indicated for young, active patients seeking to regain full functionality of the affected upper extremity.
In short, after the pectoralis major is identified, the insertion site is revealed just lateral to the biceps tendon. The site for the bone trough is then exposed through cauterization of superficial tissue, and a cortical bone trough is drilled vertically using a small round burr. The location of 3 pilot holes is identified just lateral to the cortical bone trough, and then the holes are drilled to allow for placement of the anchors later in the procedure. The tendon itself is then identified, and sutures are placed in the bulk of the muscle tendon in a Krackow fashion. After the tendon is properly sutured, it is placed under tension to test the structural integrity of the suture pattern and ensure proper load capacity. The sutures are then passed through the pilot holes, the tendon is pulled down into the trough, and the sutures are tied down to the bone.
After an appropriate rehabilitation protocol is followed for up to 6 months postoperatively, the transosseous suture technique in the context of pectoralis major tendon repairs allows for adequate tissue to bone healing and near-complete restoration of patient functionality and strength.
Acute repair of pectoralis major tendon tears using a transosseous suture technique is effective in restoring upper extremity strength and functionality and is associated with high patient satisfaction.The author(s) attests that consent has been obtained from any patient(s) appearing in this publication. If the individual may be identifiable, the author(s) has included a statement of release or other written form of approval from the patient(s) with this submission for publication.
胸大肌断裂是一种罕见的损伤，发生于20至40岁的年轻男性，通常在肌肉收缩的离心阶段进行阻力训练时出现。随着这些断裂的发生率随着活动水平的增加和合成代谢类固醇的使用而上升，了解有效的修复技术很重要。
胸大肌腱断裂的修复适用于寻求恢复受影响上肢全部功能的年轻、活跃患者。
简而言之，确定胸大肌后，在肱二头肌腱外侧显露其止点部位。然后通过烧灼浅表组织暴露骨槽部位，用小圆钻垂直钻出皮质骨槽。在皮质骨槽外侧确定3个导针孔的位置，然后钻孔以便在后续操作中置入锚钉。接着识别肌腱本身，以Krackow缝合法在肌腱主体部位放置缝线。肌腱妥善缝合后，施加张力以测试缝线模式的结构完整性并确保适当的负荷能力。然后将缝线穿过导针孔，将肌腱拉入骨槽，缝线固定于骨上。
术后遵循适当的康复方案长达6个月后，胸大肌腱修复中的经骨缝合法可实现充分的组织与骨愈合，并使患者功能和力量近乎完全恢复。
采用经骨缝合法对胸大肌腱急性撕裂进行修复可有效恢复上肢力量和功能，且患者满意度高。作者证明已获得本出版物中出现的任何患者的同意。如果个体可被识别，作者已随本投稿附上患者的豁免声明或其他书面批准形式以供发表。
