Head Of Pectoralis Major Muscle Research Articles

PERIOPERATIVE ANAESTHESIA CARE : IN POLAND SYNDROME - A RARE CASE REPORT.

Poland syndrome (PS) is a rare musculoskeletal congenital anomaly with variable presentations . Incidence is 1/30,000 live births, more often seen in males than females (3:1). Several theories have been proposed regarding the genesis of PS as vascular disruption theory “ The subclavian artery disruption sequence”. Clinical features include cardiovascular (dextrocardia, atrial septal defects) musculoskeletal (club foot, toe syndactly, hemi vertebrae and scoliosis) genitourinary (renal aplasia and hypospadiasis) hemopoietic (spherocytosis and myelogenous leukemia, lymphoma) abnormalities. Absence of sternal head of pectoralis major muscle is an essential feature of PS and most often it manifests as ipsilateral thoracic cage and upper limb anomalies. Clinical features are phenotypically variable and manifestations are often subtle in infancy and childhood delaying their diagnosis and plan for intervention. PS patients does not always have functional defects but they present for cosmetic surgical repair where the safe anaesthetic intervention need to be planned .

A new variety of chondrocoracoideus muscle, or an additional head of pectoralis major muscle

The pectoralis major and pectoralis minor muscles are located in the anterior chest wall. This region is characterized by high morphological variability. During dissection an additional muscle was found, originating from the lateral border of the pectoralis major muscle. After fusion it passed into the tendinous part coursing under the insertion of the pectoralis major muscle, then formed a common junction with the short head of the biceps brachii muscle, the distal attachment of which is on the coracoid process. Such an accessory structure could lead to neurovascular compression and cause thoracic outlet syndrome, of which pain is usually the first symptom. This muscle has not been described in the literature so far and for that reason we can name the present case as an unique structure.

Correction of Poland Syndrome (Chest Hypoplasia) Using Polymethylmethacrylate Implant

Poland anomaly (PA), also known as Poland syndrome, was first described by Alfred Poland as a unilateral underdevelopment or absence of the chest muscle, often associated with deformities such as syndactyly and chest wall deformity [1,2] Poland syndrome is characterized by a variable clinical presentation. The classical deformity consists of unilateral hypoplasia or aplasia of the sternocostal head of pectoralis major muscle and ipsilateral hand malformations. In addition, hypoplasia or aplasia of the breast is observed on the affected side in women.

Fracture of the clavicle following the island type of pectoralis major myocutaneous flap for reconstruction of head and neck defect

Fractures of the clavicle following radical neck dissection (RND) and/or radiation therapy have been previously noted in the literature. Interestingly, we experienced three cases of clavicular fracture, which were considered to have resulted from pectoralis major myocutaneous flap (PMMCF). All of these three cases had received the combined treatment of RND, PMMCF and postoperative radiotherapy on the side of fracture. In all three cases, ipsilateral lower neck received 4,500 cGy and island type of PMMCF was used for reconstruction of surgical defect in head and neck area. All fractures noted between 1 and 3 years postoperatively occurred on the medial portion of the clavicle. Devascularization after stripping of periosteum and altered mechanics of the clavicle following resection of clavicular head of pectoralis major muscle may contribute to develop this rare complication in addition to the effect of radiotherapy and RND. We present three cases of the clavicle fracture following the island type PMMCF with a review of literature.

An unusual innervation of pectoralis minor and major muscles from a branch of the intercostobrachial nerve

Variations of the branching pattern of the intercostobrachial nerve have been known to complicate dissection during mastectomy and other procedures involving the axilla. We present a unilateral case of a 73-year-old Caucasian female, in which the intercostobrachial nerve gives rise to an additional medial pectoral branch, which partially innervates the pectoralis minor muscle, as well as the abdominal head of pectoralis major muscle. Clinical consequences of such a variation may include motor losses, in addition to the commonly reported sensory losses, resulting from accidental or intentional dissection of the intercostobranchial nerve.

SURGICAL REPAIR OF PECTORALIS MAJOR RUPTURE

HISTORY: 22 year old male bodybuilder with history of anabolic steroid use with acute onset of left chest pain while bench pressing. Complains of pain and weakness with attempted bench press. PHYSICAL EXAM: Muscular young male. Gross deformity of left pectoralis musculature with loss of normal pectoralis contour. Full range of motion of left shoulder. Weakness in internal rotation and adduction. (photo of patient) DIFFERENTIAL DIAGNOSIS: Partial vs complete rupture of pectoralis major muscle TEST AND RESULTS: MRI of left chest/upper humerus demostrates complete rupture through the musculotendinous portion of sternal head of pectoralis major muscle. Intact tendon insertion of sternal head and intact clavicular head of pectorilis major. (images) FINAL DIAGNOSIS: Complete tear of sternal head of pectoralis major muscle through musculotendinous junction TREATMENT: Surgical repair of sternal head of pectoralis major muscle (surgical photos)

The clavicular head of pectoralis major musculocutaneous free flap

A new free flap is described based on the deltoid vessels of the acromiothoracic axis. The flap is comprised of the clavicular head of pectoralis major muscle with overlying skin. It is also possible to harvest vascularised clavicular bone with the flap. The vascular anatomy is reviewed and the technique of raising the flap described. Its clinical application is illustrated with five cases. Four of these were intra-oral reconstructions and the fifth a composite osteo-musculocutaneous flap to a lower limb following trauma.