PERTORALIS MAJOR REPAIR
The pectoralis major muscle is located on the front of the chest. The pectoralis major originates from two heads: the clavicular (collarbone) and the sternal (breastbone) heads. The two heads unite to form a tendon, and the tendon inserts on the humerus bone below the shoulder joint. The pectoralis plays an important role in internal rotation (rotating the shoulder toward the body) and adduction (bringing the arm toward the body). A tear of the pectoralis major usually occurs during weight-lifting with the shoulder in an externally rotated or extended position. A common exercise associated with pectoralis major tears is the bench press. A tear of the pectoralis major leads to swelling, bruising, pain, and weakness. A tear of the pectoralis major can cause significant weakness and cosmetic deformity, and Dr. Welch may recommend surgery for some patients
During surgery, Dr.Welch makes an incision on the front of the shoulder and then identifies the torn tendon. Dr. Welch then locates the area on the humerus bone where the tendon tore. Dr. Welch then inserts two or three suture anchors (medical screws with sutures) or a “cortical button” into the humerus bone and passes the sutures through the torn tendon. Dr. Welch then tensions the torn pectoralis tendon back down to the humerus and ties strong knots.
Following surgery, patients are placed in a sling for comfort. The arm is positioned in a neutral or internally-rotated position. This position keeps tension off of the repaired tissue. Dr. Welch recommends intermittent icing and gentle range of motion following surgery. Dr. Welch also recommends starting physical therapy 2-4 weeks after surgery. Physical therapy focuses on reducing swelling in the shoulder, restoring range of motion, and eventually, restoring strength to the shoulder. It is very important to follow the rehabilitation process carefully to achieve the best outcome.