Pectoralis Tendon Repair

Pectoralis Tendon Repair

What is Pectoralis Tendon Repair?

Pectoralis tendon repair is a surgical procedure to fix a torn pectoralis major tendon, typically caused by high-impact activities or sudden heavy lifting, especially in athletes. During the procedure, the torn tendon is reattached to the humerus (upper arm bone), often using sutures or anchors, to restore shoulder strength and function. Recovery includes a period of immobilization, followed by a structured rehabilitation program to regain shoulder mobility and strength.

The pectoralis major tendon connects the pectoralis major muscle (a large chest muscle responsible for shoulder and arm movement) to the upper arm bone (humerus). This muscle allows actions such as pushing, lifting, and arm rotation, making it crucial for many daily activities and sports movements.

Indications for Pectoralis Tendon Repair

Pectoralis tendon repair is indicated primarily for complete tears, especially in active individuals or athletes who need full shoulder function. Surgery is recommended if there is significant weakness, loss of shoulder strength, or noticeable deformity in the chest area. It is also considered when nonsurgical treatments, such as physical therapy and activity modification, do not relieve symptoms or restore shoulder function, or for those with high physical demands in work or sports.

Preparation for Pectoralis Tendon Repair

Preparation for pectoralis tendon repair may include the following:

• A comprehensive medical evaluation including physical exams, review of medical history, blood work, and imaging (MRI or ultrasound) to confirm the injury's extent and ensure the patient is fit for surgery
• Informing your doctor of any allergies to medications, anesthesia, or latex
• Providing your physician with a list of any medications or supplements you are taking
• You may need to adjust or temporarily stop taking certain medications - especially those that can affect blood clotting
• Abstaining from food or drink for at least 8 hours prior to surgery
• Signing an informed consent form after the pros and cons of the surgery have been explained

Procedure for Pectoralis Tendon Repair

In general, the procedure for pectoralis tendon repair may involve the following steps:

• The patient is typically placed under general anesthesia to ensure the patient is comfortable and pain-free throughout the procedure.
• The patient is usually positioned supine (lying on the back) with the arm slightly extended to expose the shoulder.
• An incision is made near the axillary fold (front of the armpit) to access the pectoralis tendon and humerus.
• The torn tendon is carefully identified and mobilized to enable reattachment.
• The humeral attachment site is prepared by debriding the surface to allow for optimal tendon reattachment and healing.
• Strong sutures and bone anchors are used to reattach the tendon to the humerus.
• Depending on the tear's location, the tendon may be secured using a single or double-row suture anchor technique for extra stability.
• Finally, the incision is closed with sutures or staples, and a bandage is applied.

Postoperative Care and Recovery

After surgery, the arm is typically placed in a sling or brace for several weeks to limit movement and protect the repair. Pain medications and anti-inflammatory drugs are provided to manage pain and reduce swelling. Wound care instructions are provided to keep the surgical site clean and dry. A structured rehabilitation program usually begins within a few weeks post-surgery, starting with gentle range-of-motion exercises and gradually progressing to strengthening exercises. Patients are advised to avoid heavy lifting, pushing, or pulling with the affected arm for several weeks or as directed by the surgeon. Full recovery can take 4-6 months, with athletes or physically active patients sometimes requiring a bit longer to regain strength and function. Follow-up visits will be scheduled to monitor healing, assess function, and adjust rehabilitation protocols as needed.

Risks and Complications

Pectoralis tendon repair is generally safe, but as with any surgical procedure, there are potential risks and complications that may occur, such as:

• Infection
• Bleeding
• Tendon re-rupture
• Stiffness and limited range of motion
• Nerve injury
• Accumulation of blood (hematoma) or fluid (seroma)
• Persistent pain
• Delayed healing