Clinical results of a surgical technique using endobuttons for complete tendon tear of pectoralis major muscle: report of five cases

Eiji Shimpuku,Yoshiyasu Uchiyama,Seiji Miyazaki,Akiyoshi Handa,Joji Mochida,Tetsuro Tamaki,Hiroko Omi

doi:10.1186/1758-2555-3-20

Eiji Shimpuku, Yoshiyasu Uchiyama + Show 5 more

Open Access

https://doi.org/10.1186/1758-2555-3-20

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Abstract

BackgroundWe herein describe a surgical technique for the repair of complete tear of the pectoralis major (PM) tendon using endobuttons to strengthen initial fixation.MethodsFive male patients (3 judo players, 1 martial arts player, and 1 body builder) were treated within 2 weeks of sustaining complete tear of the PM tendon. Average age at surgery and follow-up period were 28.4 years (range, 23-33) and 28.8 months (range, 24-36). A rectangular bone trough (about 1 × 4 cm) was created on the humerus at the insertion of the distal PM tendon. The tendon stump was introduced into this trough, and fixed to the reverse side of the humeral cortex using endobuttons and non-absorbable suture. Clinical assessment of re-tear was examined by MRI. Shoulder range of motion (ROM), outcome of treatment, and isometric power were measured at final follow-up.ResultsThere were no clinical re-tears, and MRI findings also showed continuity of the PM tendon in all cases at final follow-up. Average ROM did not differ significantly between the affected and unaffected shoulders. The clinical outcomes at final follow-up were excellent (4/5 cases) or good (1/5). In addition, postoperative isometric power in horizontal flexion of the affected shoulder showed complete recovery when compared with the unaffected side.ConclusionsSatisfactory outcomes could be obtained when surgery using the endobutton technique was performed within 2 weeks after complete tear of the PM tendon. Therefore, our new technique appears promising as a useful method to treat complete tear of the PM tendon.

Highlights

We describe a surgical technique for the repair of complete tear of the pectoralis major (PM) tendon using endobuttons to strengthen initial fixation
In order to address these concerns among competitive athletes, we considered it necessary to create a surgical technique with strong initial fixation of the insertion of the PM
Endobuttons and strong sutures have been used as initial stronger fixing materials to bear considerable physical stress such as that encountered in the correction of tear of the anterior cruciate ligament of the knee [15], tear of the distal biceps tendon [16], separation of the distal tibiofibular joint [17], and separation of the acromioclavicular joint [18]

Summary

Introduction

We describe a surgical technique for the repair of complete tear of the pectoralis major (PM) tendon using endobuttons to strengthen initial fixation. The pectoralis major (PM) muscle is a powerful adductor, flexor, and internal rotator of the shoulder, and contributes considerably to upper-body power and motor capacity. Complete tear of PM is considered a severe, incapacitating sports injury. Several surgical techniques have been reported for complete tears of PM [3,6,7,8]. PM is the major muscle of the upper body and contributes considerably to motor capacity. In order to address these concerns among competitive athletes, we considered it necessary to create a surgical technique with strong initial fixation of the insertion of the PM tendon

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