Rupture of the pectoralis major muscle - Outcome after repair of acute andchronic injuries

We retrospectively studied 17 cases of distal pectoralis major muscle ruptu re to compare the results of repair in acute and chronic injuries and to co mpare operative and nonoperative treatment. Thirteen patients underwent sur gery (six acute injuries [less than 2 weeks after injury] and seven chronic injuries) and four had nonoperative management. The mean age of the patien ts at injury was 29, and 10 of the 17 injuries were the result of weight li fting. Follow-up ranged from 18 months to 6 years (mean, 28 months). All pa tients subjectively rated strength, pain, motion, function with strenuous s porting activities, cosmesis, and overall satisfaction. Objectively, patien ts were examined for range of motion, deformity, atrophy, and strength. Iso kinetic strength testing was performed in eight patients: six treated opera tively (three acute and three chronic) and two treated nonoperatively. Over all subjective ratings were 96% in the acute group, 93% in the chronic grou p, and only 51% in the nonoperative group. Isokinetic testing showed that p atients operated on for acute injuries had the highest adduction strength ( 102% of the opposite side) compared with patients with chronic injuries (94 %) or nonoperative treatment (71%), There were no statistically significant subjective or objective differences in outcome between the patients treate d operatively for acute or chronic injuries, but these patients fared signi ficantly better than patients treated nonoperatively.