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BMJ Case Reports May 2021Poland's syndrome (PS) is a rare developmental anomaly that can manifest mild (pectoralis muscles involvement) to severe deformities (rib hypoplasia and hand...
Poland's syndrome (PS) is a rare developmental anomaly that can manifest mild (pectoralis muscles involvement) to severe deformities (rib hypoplasia and hand deformities). We report a case of 69-year-old man who presented to the emergency department with a traumatic chest injury after a fall. It was initially thought to have a significant chest injury as the trauma survey revealed a palpable defect and tenderness in the right anterior chest wall. There was also a symbrachydactyly deformity in the right hand. CT of the chest showed lack of right pectoralis muscles, which were consistent with PS. This case highlights the importance of gathering detail history in adult trauma patients such as congenital disorder especially in the presence of bony deformity. With possibilities of several traumatic conditions in trauma patients eliminated, one can expand the non-traumatic differential, keeping in mind the possibility of a congenital disorder that can mimic traumatic chest injury.
Topics: Adult; Aged; Humans; Male; Pectoralis Muscles; Poland Syndrome; Syndactyly; Thoracic Injuries; Thorax
PubMed: 34059541
DOI: 10.1136/bcr-2020-241408 -
Respiratory Research Apr 2018Low muscle mass is associated with increased mortality in the general population but its prognostic value in at-risk smokers, those without expiratory airflow...
BACKGROUND
Low muscle mass is associated with increased mortality in the general population but its prognostic value in at-risk smokers, those without expiratory airflow obstruction, is unknown. We aimed to test the hypothesis that reduced muscle mass is associated with increased mortality in at-risk smokers.
METHODS
Measures of both pectoralis and paravertebral erector spinae muscle cross-sectional area (PMA and PVMA, respectively) as well as emphysema on chest computed tomography (CT) scans were performed in 3705 current and former at-risk smokers (≥10 pack-years) aged 45-80 years enrolled into the COPDGene Study between 2008 and 2013. Vital status was ascertained through death certificate. The association between low muscle mass and mortality was assessed using Cox regression analysis.
RESULTS
During a median of 6.5 years of follow-up, 212 (5.7%) at-risk smokers died. At-risk smokers in the lowest (vs. highest) sex-specific quartile of PMA but not PVMA had 84% higher risk of death in adjusted models for demographics, smoking, dyspnea, comorbidities, exercise capacity, lung function, emphysema on CT, and coronary artery calcium content (hazard ratio [HR] 1.85 95% Confidence interval [1.14-3.00] P = 0.01). Results were consistent when the PMA index (PMA/height) was used instead of quartiles. The association between PMA and death was modified by smoking status (P = 0.04). Current smokers had a significantly increased risk of death (lowest vs. highest PMA quartile, HR 2.25 [1.25-4.03] P = 0.007) while former smokers did not.
CONCLUSIONS
Low muscle mass as measured on chest CT scans is associated with increased mortality in current smokers without airflow obstruction.
TRIAL REGISTRATION
NCT00608764.
Topics: Aged; Aged, 80 and over; Cross-Sectional Studies; Female; Follow-Up Studies; Humans; Male; Middle Aged; Mortality; Muscle Strength; Pectoralis Muscles; Pulmonary Disease, Chronic Obstructive; Risk Factors; Smokers; Smoking; Tomography, X-Ray Computed
PubMed: 29636050
DOI: 10.1186/s12931-018-0771-6 -
Annals of Anatomy = Anatomischer... Aug 2023The pectoralis major muscle is located in the anterior chest wall. In most cases, it is divided into clavicular, sternal (sternocostal) and abdominal heads. The aim of...
BACKGROUND
The pectoralis major muscle is located in the anterior chest wall. In most cases, it is divided into clavicular, sternal (sternocostal) and abdominal heads. The aim of this study is to demonstrate and classify the morphological variability of the pectoralis major muscles in human fetuses.
MATERIAL AND METHODS
Classical anatomical dissection was performed on 35 human fetuses aged 18-38 weeks of gestation at death were examined. (17 female, and 18 male, 70 sides; fixed in 10% formalin solution). The fetuses were obtained from spontaneous abortion after informed consent of both parents and through deliberate donation to the Medical University anatomy program. Upon dissection, the following morphological features were assessed: the morphology of the pectoralis major, the possible occurrence of accessory heads, the possible absence of some head, and morphometric measurements of each head of the pectoralis major muscle.
RESULTS
Five types of morphology (based on number of bellies) were observed in the fetuses. Type I was characterized by a single claviculosternal belly (10% of all samples). Type II comprised the clavicular and sternal heads (37.1%). Type III comprised three clavicular, sternal and abdominal heads (31.4%). Type IV (17.2%) was characterized by four muscle bellies and was divided into four subtypes. Type V (4.3%), was represented by five parts, and was divided into two subtypes.
CONCLUSIONS
Due to its embryological development, the PM demonstrates great variability in the numbers of its parts. The most common type was the PM with two bellies, in line with previous studies which also distinguished only clavicular and sternal heads.
Topics: Humans; Male; Female; Pectoralis Muscles; Clavicle; Dissection; Cadaver
PubMed: 37211259
DOI: 10.1016/j.aanat.2023.152108 -
Lin Chuang Er Bi Yan Hou Tou Jing Wai... Jul 2021The pectoralis major muscle flap has been clinically used for more than 40 years. When harvesting the traditional pectoralis major muscle flaps, it is necessary to cut...
The pectoralis major muscle flap has been clinically used for more than 40 years. When harvesting the traditional pectoralis major muscle flaps, it is necessary to cut the upper half of the pectoralis major muscle, and use the thoracoacromial vessels and its surrounding pectoralis major muscle as the pedicle, resulting in the loss of the function of the pectoralis major muscle. Hypertrophic pedicle also squeezes the responsible vessels and prevents the flap from being transferred to recipient area, often leading to the partial necrosis of the flap end. The author proposes an improved method to harvesting pectoralis major muscle island flap, and summarizes it as a "ten-step procedures". The key point is to identify the "lowest penetrating muscle point"(LPMP) during the operation, and points out that it is safe to cut off the muscle pedicle 2cm above LPMP. The pectoralis major muscle island flaps not only preserves the function of the donor site's pectoralis major muscle to the utmost extent, better restores the swallowing and vocal function of the recipient site, but also improves the safety of flap harvesting, which will be benefit to patients.
Topics: Humans; Pectoralis Muscles; Plastic Surgery Procedures; Surgical Flaps
PubMed: 34304496
DOI: 10.13201/j.issn.2096-7993.2021.07.014 -
In Vivo (Athens, Greece) 2023Silicone implants or tissue expanders placed under the pectoralis major (PM) muscle are often used for breast reconstruction. However, the disruption of PM insertions,... (Review)
Review
Silicone implants or tissue expanders placed under the pectoralis major (PM) muscle are often used for breast reconstruction. However, the disruption of PM insertions, which is often an inevitable part of the surgical procedure, is known to cause PM morbidity and, subsequently, problems with the use of the ipsilateral arm. In this systematic review, we present current knowledge regarding the effect of submuscular silicone-based breast reconstruction on the function of PM and the ipsilateral arm. A search of the relevant English literature was performed through PubMed and ten eligible studies were identified. Articles reporting breast augmentation were accepted as the techniques of implant insertion are similar to reconstruction. Questionnaires reporting the status of the arm, analysis of the range of motion of the shoulder with 3-D video, isometric or isokinetic dynamometry, ultrasound shear-wave elastography, volumetric MRI, electromyography and light and electron microscopy of the PM fibers were used for the assessment of PM and arm status. The insertion of implants under the PM, especially when combined with dissection of some of its insertions, seems to be associated with measurable abnormal microscopic, imaging, and dynamometric findings. However, the intact part of the muscle and possibly other nearby muscular structures are able to compensate for the lost part of PM. Thus, the insertion of implants fully or partially under the PM seems to have no or little effect on the function of the ipsilateral upper limb in daily life.
Topics: Pectoralis Muscles; Silicones; Mammaplasty; Prostheses and Implants; Magnetic Resonance Imaging; Breast Implants
PubMed: 37652471
DOI: 10.21873/invivo.13289 -
The Journal of Thoracic and... Mar 2022
Topics: Humans; Lifting; Pectoralis Muscles; Retrospective Studies; Sarcopenia
PubMed: 33454105
DOI: 10.1016/j.jtcvs.2020.12.014 -
Journal of Orthopaedic Research :... Jul 2019Subpectoral implants for breast reconstruction after mastectomy requires the surgical disinsertion of the sternocostal fiber region of the pectoralis major. This...
Subpectoral implants for breast reconstruction after mastectomy requires the surgical disinsertion of the sternocostal fiber region of the pectoralis major. This technique is associated with significant shoulder strength and range of motion deficits, but it is unknown how it affects the underlying integrity of the shoulder joint or pectoralis major. The aim of this study was to characterize the long-term effects of this reconstruction approach on shoulder joint stiffness and pectoralis major material properties. Robot-assisted measures of shoulder strength and stiffness and ultrasound shear wave elastography images from the pectoralis major were acquired from 14 women an average of 549 days (range: 313-795 days) post reconstruction and 14 healthy, age-matched controls. Subpectoral implant patients were significantly weaker in shoulder adduction (p < 0.001) and exhibited lower shoulder stiffness when producing submaximal adduction torques (p = 0.004). The underlying material properties of the clavicular fiber region of the pectoralis major were altered in subpectoral implant patients, with significantly reduced shear wave velocities in the clavicular fiber region of the pectoralis major when generating adduction torques (p = 0.023). The clinical significance of these findings are that subpectoral implant patients do not fully recover shoulder strength or stability in the long-term, despite significant recovery time, and substantial shoulder musculature left intact. The impact of these procedures extends to the remaining, intact volume of the pectoralis major. Optimization of shoulder function should be a key aspect of the post-reconstruction standard of care. © 2019 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 37:1610-1619, 2019.
Topics: Female; Humans; Mammaplasty; Mastectomy; Middle Aged; Patient Reported Outcome Measures; Pectoralis Muscles; Retrospective Studies; Shoulder Joint
PubMed: 30816589
DOI: 10.1002/jor.24257 -
Journal of Sports Science & Medicine Mar 2021Increased muscle stiffness of the pectoralis minor (PMi) could deteriorate shoulder function. Stretching is useful for maintaining and improving muscle stiffness in... (Randomized Controlled Trial)
Randomized Controlled Trial
Increased muscle stiffness of the pectoralis minor (PMi) could deteriorate shoulder function. Stretching is useful for maintaining and improving muscle stiffness in rehabilitation and sport practice. However, the acute and prolonged effect of stretching on the PMi muscle stiffness is unclear due to limited methodology for assessing individual muscle stiffness. Using shear wave elastography, we explored the responses of shear modulus to stretching in the PMi over time. The first experiment (n = 20) aimed to clarify the acute change in the shear modulus during stretching. The shear modulus was measured at intervals of 30 s × 10 sets. The second experiment (n = 16) aimed to observe and compare the prolonged effect of different durations of stretching on the shear modulus. Short and long stretching duration groups underwent 30s × 1 set and 30s × 10 sets, respectively. The assessments of shear modulus were conducted before, immediately after, and at 5, 10, and 15 min post-stretching. In experiment I, the shear modulus decreased immediately after a bout (30 s) of stretching (p < 0.001, change: -2.3 kPa, effect size: = 0.72) and further decreased after 3 repetitions (i.e., 90 s) of stretching (p = 0.03, change: -1.0 kPa, effect size: = 0.53). In experiment II, the change in the shear modulus after stretching was greater in the long duration group than in the short duration group (p = 0.013, group mean difference: -2.5 kPa, partial = 0.36). The shear modulus of PMi decreased immediately after stretching, and stretching for a long duration was promising to maintain the decreased shear modulus. The acute and prolonged effects on the PMi shear modulus provide information relevant to minimum and persistent stretching time in rehabilitation and sport practice.
Topics: Adult; Analysis of Variance; Biomechanical Phenomena; Elastic Modulus; Elasticity Imaging Techniques; Humans; Male; Muscle Stretching Exercises; Muscle Tonus; Pectoralis Muscles; Time Factors
PubMed: 33707982
DOI: 10.52082/jssm.2021.17 -
Sports Health 2019Pectoralis major tendon ruptures are becoming increasingly common due to the growing prevalence of active lifestyles. Studies investigating the efficacy of pectoralis...
CONTEXT:
Pectoralis major tendon ruptures are becoming increasingly common due to the growing prevalence of active lifestyles. Studies investigating the efficacy of pectoralis major tendon repair have limited sample sizes and offer mixed results, while existing reviews do not explore postoperative activity outcomes for patients.
OBJECTIVE:
To summarize and synthesize the clinical outcomes and rate of return to activity after isolated pectoralis major tendon repair.
DATA SOURCES:
Four databases (MEDLINE, EMBASE, PubMed, and CINAHL) were searched from database inception through March 7, 2018.
STUDY SELECTION:
Studies reporting outcomes of isolated pectoralis major tendon repair for pectoralis major tendon rupture were included.
STUDY DESIGN:
Systematic review.
LEVEL OF EVIDENCE:
Level 4.
DATA EXTRACTION:
Data including patient demographics, intervention details, and clinical outcomes were extracted. The methodological quality of included studies was evaluated.
RESULTS:
Of 2332 retrieved articles, 18 studies were included, with a total of 536 patients. A majority (90%; 134/149) of patients undergoing pectoralis major tendon repair successfully returned to sport at a mean 6.1 ± 1.7 months postsurgery, of which 74% (95/128) successfully returned to their preinjury level of sport. The majority (95%; 269/284) of patients returned to work at a mean 6.9 ± 1 months. Postsurgically, 81% (83/102) of patients experienced complete pain relief after the surgery, and 19% (21/109) had cosmetic complaints after pectoralis major repair. Of the 10 studies that reported complications, 18% (75/423) of patients had postoperative complications, including reruptures and wound infections; 7% (30/423) of patients required reoperation for their complications.
CONCLUSION:
Pectoralis major tendon repair is an effective treatment that results in a high rate of return to sport and work, pain relief, and improved cosmetic appearance, albeit with a significant rate of complication. The evidence supporting all outcomes was limited by the rarity of the injury, the variable surgical techniques, and outcome assessment criteria.
Topics: Esthetics; Humans; Musculoskeletal Pain; Patient Satisfaction; Pectoralis Muscles; Postoperative Complications; Return to Sport; Rupture; Tendon Injuries; Treatment Outcome
PubMed: 30543493
DOI: 10.1177/1941738118818060 -
PloS One 2021Paralympic Powerlifting is a sport in which the strength of the upper limbs is assessed through bench press performance in an adapted specific bench. It is therefore...
Paralympic Powerlifting is a sport in which the strength of the upper limbs is assessed through bench press performance in an adapted specific bench. It is therefore essential to optimize training methods to maximize this performance. The aim of the present study was to compare force production and muscle activation involved in partial vs. full range of motion (ROM) training in Paralympic Powerlifting. Twelve male athletes of elite national level in Paralympic Powerlifting participated in the study (28.60 ± 7.60 years of age, 71.80 ± 17.90 kg of body mass). The athletes performed five sets of 5RM (repetition maximum), either with 90% of 1RM in full ROM or with a load of 130% 1RM in partial ROM. All subjects underwent both exercise conditions in consecutive weeks. Order assignment in the first week was random and counterbalanced. Fatigue index (FI), Maximum Isometric Force (MIF), Time to MIF (Time) and rate of force development (RFD) were determined by a force sensor. Muscle thickness was obtained using ultrasound images. All measures were taken pre- and post-training. Additionally, electromyographic signal (EMG) was evaluated in the last set of each exercise condition. Post-exercise fatigue was higher with full ROM as well as loss of MIF. Full ROM also induced greater. EMG showed greater activation of the Clavicular portion and Sternal portion of pectoralis major muscle and lower in the anterior portion of deltoid muscle when full ROM was performed. Muscle thickness of the pectoralis major muscle increased post-exercise. We concluded that training with partial ROM enables higher workloads with lower loss of muscle function.
Topics: Adaptation, Physiological; Adult; Humans; Male; Muscle Strength; Pectoralis Muscles; Range of Motion, Articular; Resistance Training; Weight Lifting; Young Adult
PubMed: 34644331
DOI: 10.1371/journal.pone.0257810