Abstract
The purpose of this study is to report on the causes of a series of acute pectoralis major tears in active duty deployed military personnel. Nine cases of acute pectoralis major tears evaluated at one expeditionary military treatment facility over a 4-month deployment cycle were analyzed. Nine male patients were diagnosed with tears: seven complete tears at the tendinous insertion, one complete tear at the musculotendinous junction, and one incomplete tear, with a mean age of 32 years (range, 23-52 years). All injuries occurred during bench press, with the dominant upper extremity involved 56% of the time. Injury occurred an average of 77 days into the tour (range, 3-198 days). Mean time from injury to surgical repair in the cohort was 18 days (range, 10-43 days). Combat-deployed active duty U.S. military personnel likely represent a high-risk population for this injury. Surgical repair is possible, but rarely advisable, in the deployed setting. (Journal of Surgical Orthopaedic Advances 28(2):150-157, 2019).
Highlights
As sport related activities and weight training broaden in popularity, the incidence of pectoralis major tears appears to be increasing
The purpose of our study is to report on the causes of a series of pectoralis major tears at one expeditionary medical treatment facility (MTF) over a four month deployment cycle, identify any patient specific risk factors and to confirm that in-theater surgical repair is possible in most cases
All injuries occurred during bench press with a mean weight of 258 lbs (135-415 lbs), with the dominant upper extremity involved 56% of the time
Summary
As sport related activities and weight training broaden in popularity, the incidence of pectoralis major tears appears to be increasing. During the deep part of the bench press repetition, the pectoralis major tendon is most prone to rupture during eccentric contraction with the arm positioned in 30 degrees of extension and 40 degrees of abduction [6]. In this position the inferior most fibers of the tendon are at a distinct mechanical disadvantage and undergo twice the excursion of the superior fibers [6]. As sport related activities and weight training broaden in popularity, the incidence of pectoralis major tears appears to increase [1,2,5,7]
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