Abstracts Posters SICOT-SOF meeting Gothenburg 2010 _2_

Poster
Topic: General Orthopaedics
Abstract number: 25162
AN UNUSUAL MECHANISM OF PECTORALIS MAJOR RUPTURE- RISK OF
TRAPEZE OVERHEAD BAR IN HOSPITAL BEDS FOR ELDERLY PATIENTS
Sitaram GIRI, Brian BANERJEE
Good Hope Hospital, Sutton Coldfield (UNITED KINGDOM)
Pectoralis major rupture is an uncommon entity and is mainly an athletic injury
commonly seen in activities like weight lifting, bench press or while performing
weighted parallel bar dips. The injury may be missed initially due to its uncommon
nature and lack of awareness amongst the treating physicians. The tear occurs with
decreasing frequency at musculotendinous junction, humeral insertion and the
muscle belly. Being an injury in active individuals, surgical treatment is usually
recommended but for partial or more proximal ruptures conservative treatment may
be used. In elderly patients this injury is suspected to be more common than
reported. We here present an unusual mechanism for rupture of the pectoralis major
which has never been reported in literature. A 91 year old lady admitted into an
orthopaedic with an undisplaced periprosthetic hip fracture which was treated nonoperatively.
While attempting to lift herself up with the help of a monkey bar attached
to the bed she developed sharp pain in her right chest wall. Next day she was found
to have bruising and tender lump in upper- outer chest wall. An ultrasound scan was
performed, which revealed a complete tear involving the muscle belly of the
pectoralis major. She was treated symptomatically with anti-inflammatory and rest
followed by progressive functional use of her arm. On review at 3 months she was
asymptomatic and had no functional disability. A review of literature discussing the
pathomechanics and treatment recommendations for pectoralis major injuries are
discussed.
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