OBJECTIVE: To express the significance and report the clinical outcomes of active duty military patients who underwent direct pectoralis major repairs in a chronic setting. METHODS: Retrospective review of data collected on 16 active duty military patients who underwent direct repair of a chronic pectoralis major tear. Pre-operative and post-operative evaluations (minimum 2 year follow up; mean, 53.46 months; range, 24-88 months) included range of motion, Bak classification, visual analog scale (VAS), Single Assessment Numerical Evaluation (SANE) Score, Quick Disabilities of the Arm, Shoulder and Hand (DASH) Score, and American Shoulder and Elbow Surgeons (ASES) Shoulder Score. RESULTS: Using a Bak classification, 94% (15/16) of patients were reported with good or excellent results. Mean VAS score improved from 7.08 ± 1.66 to 0.54 ± 1.20 (p < 0.0001). Mean SANE score improved from 42.31 ± 19.96 to 94.62 ± 5.94 (p < 0.0001). The average Quick DASH score increased from 55.42 ± 15.34 to 7.30 ± 6.39 (p < 0.0001). The average ASES score increased from 48.71 ± 13.80 to 94.62 ± 7.63 (p < 0.0001). There was no loss of motion after surgery in forward flexion, external rotation or internal rotation. The average internal rotation muscle power increased from 4.15 ± 0.48 to 4.92 ± 0.28 (p < 0.0001). COMPLICATIONS: 6.25% (1/16) patients developed a keloid scar, tender to direct pressure post-operatively. 94% (15/16) of patients returned to their pre-operative level of recreational and military job activity. CONCLUSION: Military patients who underwent direct repair of a chronic pectoralis major tear had excellent clinical outcomes, low risk of complications, and a high return to pre-operative level of recreational and military job activity. LEVEL OF EVIDENCE: Case Series; IV.
OBJECTIVE: To express the significance and report the clinical outcomes of active duty military patients who underwent direct pectoralis major repairs in a chronic setting. METHODS: Retrospective review of data collected on 16 active duty military patients who underwent direct repair of a chronic pectoralis major tear. Pre-operative and post-operative evaluations (minimum 2 year follow up; mean, 53.46 months; range, 24-88 months) included range of motion, Bak classification, visual analog scale (VAS), Single Assessment Numerical Evaluation (SANE) Score, Quick Disabilities of the Arm, Shoulder and Hand (DASH) Score, and American Shoulder and Elbow Surgeons (ASES) Shoulder Score. RESULTS: Using a Bak classification, 94% (15/16) of patients were reported with good or excellent results. Mean VAS score improved from 7.08 ± 1.66 to 0.54 ± 1.20 (p < 0.0001). Mean SANE score improved from 42.31 ± 19.96 to 94.62 ± 5.94 (p < 0.0001). The average Quick DASH score increased from 55.42 ± 15.34 to 7.30 ± 6.39 (p < 0.0001). The average ASES score increased from 48.71 ± 13.80 to 94.62 ± 7.63 (p < 0.0001). There was no loss of motion after surgery in forward flexion, external rotation or internal rotation. The average internal rotation muscle power increased from 4.15 ± 0.48 to 4.92 ± 0.28 (p < 0.0001). COMPLICATIONS: 6.25% (1/16) patients developed a keloid scar, tender to direct pressure post-operatively. 94% (15/16) of patients returned to their pre-operative level of recreational and military job activity. CONCLUSION: Military patients who underwent direct repair of a chronic pectoralis major tear had excellent clinical outcomes, low risk of complications, and a high return to pre-operative level of recreational and military job activity. LEVEL OF EVIDENCE: Case Series; IV.
Authors: Avinesh Agarwalla; Anirudh K Gowd; Joseph N Liu; Grant H Garcia; Gregory P Nicholson; Brian Forsythe; Anthony A Romeo; Nikhil N Verma Journal: Orthop J Sports Med Date: 2021-12-15