title: Outcome of repair of chronic tear of the pectoralis major using corkscrew suture anchors by box suture sliding technique.
abstract: OBJECTIVE
  To assess the functional and clinical results of repair of chronic tears of pectoralis major using corkscrew and sliding suture technique.
  
  
  METHODS
  In this retrospective study, we reviewed the results of pectoralis major repair in 11 chronic cases (> 6 wk) done between September 2011 and December 2014 at our institute. In all cases repair was done by same surgeon using corkscrew suture anchors and box suture sliding technique. At 6 mo, after surgery magnetic resonance imaging was done to see the integrity of the repair. Functional evaluation was done using Penn and ASES scores. Pre and postoperative Isokinetic strength was measured.
  
  
  RESULTS
  Average follow-up was 48.27 ± 21.0 mo. The Wilcoxon signed rank test was used to evaluate the outcome scores. The average ASES score increased from an average of 54.63 ± 13.0 preoperatively to 95.09 ± 2.60 after surgery at their last follow-up. The average Penn score also increased from 5.72 ± 0.78, 2.81 ± 1.32 and 45.81 ± 1.72 to 9.36 ± 0.80, 8.27 ± 0.90 and 59 ± 1.34 for pain, satisfaction and function respectively. Follow up magnetic resonance imaging (MRI) (at 6 mo) showed continuity and the bulk of pectoralis major muscle in all cases. Average isokinetic strength deficiency in horizontal adduction at 60° was 13.63% ± 6.93% and at 120° was 10.18% ± 4.93% and in flexion at 60° was 10.72% ± 5.08% and at 120° was 6.63% + 3.74%. Results showed that both ASES and Penn score improved significantly (2 tailedPvalue = 0.0036).
  
  
  CONCLUSIONS
  We could conclude from this series that pectoralis major repair even in chronic cases using 5.5 mm corkscrew anchors give excellent functional and cosmetic results. In chronic cases the repairable length of the tendon is not available and sliding suture technique allows for fixation of worn out tendomuscular junction to bone without letting cutting through the muscle.
authors: Deepak Joshi, Jitesh Kumar Jain, Deepak Chaudhary, Utkarsh Singh, Sports Injury Centre, Safdarjung Hospital, New Delhi 110029, India.
authors: Deepak
authors: D
authors: Joshi
authors: Deepak Joshi, Jitesh Kumar Jain, Deepak Chaudhary, Utkarsh Singh, Sports Injury Centre, Safdarjung Hospital, New Delhi 110029, India.
authors: Jitesh Kumar
authors: JK
authors: Jain
authors: Deepak Joshi, Jitesh Kumar Jain, Deepak Chaudhary, Utkarsh Singh, Sports Injury Centre, Safdarjung Hospital, New Delhi 110029, India.
authors: Deepak
authors: D
authors: Chaudhary
authors: Deepak Joshi, Jitesh Kumar Jain, Deepak Chaudhary, Utkarsh Singh, Sports Injury Centre, Safdarjung Hospital, New Delhi 110029, India.
authors: Utkarsh
authors: U
authors: Singh
authors: Deepak Joshi, Jitesh Kumar Jain, Deepak Chaudhary, Utkarsh Singh, Sports Injury Centre, Safdarjung Hospital, New Delhi 110029, India.
authors: Vineet
authors: V
authors: Jain
authors: Deepak Joshi, Jitesh Kumar Jain, Deepak Chaudhary, Utkarsh Singh, Sports Injury Centre, Safdarjung Hospital, New Delhi 110029, India.
authors: Ajay
authors: A
authors: Lal
keywords: Bench press; Chronic tears; Corkscrew suture anchors; Pectoralis major tear; Tendon repair