Pectoralis major ruptures in professional American football players.

BACKGROUND: Pectoralis major injuries are an infrequent shoulder injury that can result in pain, weakness, and deformity. These injuries may occur during the course of an athletic competition, including football. The purpose of this study was to determine the incidence of pectoralis major ruptures in professional football players and time lost from the sport following injury. We hypothesized that ruptures most frequently occur during bench-press strength training. METHODS: The National Football League Injury Surveillance System was reviewed for all pectoralis major injuries in all players from 2000 to 2010. Details regarding injury setting, player demographics, method of treatment, and time lost were recorded. RESULTS: A total of 10 injuries-complete ruptures-were identified during this period. Five of the 10 were sustained in defensive players, generally while tackling. Nine occurred during game situations, and 1 occurred during practice. Specific data pertinent to the practice injury was not available. No rupture occurred during weight lifting. Eight ruptures were treated operatively, and 2 cases did not report the method of definitive treatment. The average days lost was 111 days (range, 42-189). The incidence was 0.004 pectoralis major ruptures during the 11-year study period. CONCLUSIONS: Pectoralis major injuries are uncommon while playing football. In the National Football League, these injuries primarily occur not during practice or while bench pressing but rather during games. When pectoralis major ruptures do occur, they are successfully treated operatively. Surgery may allow for return to full sports participation. LEVEL OF EVIDENCE: IV, case series.

TightRope versus fiber mesh tape augmentation of acromioclavicular joint reconstruction: a biomechanical study.

BACKGROUND: The standard Weaver-Dunn reconstruction of the acromioclavicular (AC) joint does not provide adequate superoinferior or anteroposterior stability. Augmentation methods such as tape cerclage have been described. A new method of augmentation with the Arthrex TightRope is available. HYPOTHESIS: A Weaver-Dunn reconstruction augmented with the TightRope will provide superior superoinferior and anteroposterior stability to the AC joint as compared with a Weaver-Dunn reconstruction augmented with Mersilene fiber tape cerclage. STUDY DESIGN: Controlled laboratory study. METHODS: Six matched pairs of cadaveric shoulders underwent Weaver-Dunn AC joint reconstructions and were randomly assigned to receive either the TightRope device or tape cerclage augmentation. Translation in 2 planes was measured in the intact state under load and after 1 load cycle and 2000 load cycles. RESULTS: TightRope-augmented repair showed less superoinferior translation (mean +/- standard error) than cerclage-augmented repair in initially repaired (1.6 +/- 0.1 mm vs 5.0 +/- 1.1 mm, P = 0.03) and cyclically loaded (2.1 +/- 0.1 mm vs 5.8 +/- 1.2 mm, P = 0.02) conditions. TightRope repairs were stiffer than the native ligaments in the superoinferior plane. Less anteroposterior translation was observed with TightRope versus cerclage augmentation (initially repaired, 6.8 +/- 0.4 mm vs 18.8 +/- 2.6 mm, P < 0.001; cycled, 15.0 +/- 1.4 mm vs 28.3 +/- 2.7 mm, P = 0.01), but neither method maintained normal anteroposterior laxity after 1500 cycles compared with the intact state. CONCLUSION: Superoinferior and anteroposterior translation with TightRope augmentation was lower than with tape cerclage. CLINICAL RELEVANCE: TightRope augmentation of a Weaver-Dunn procedure could provide increased protection for AC joint reconstruction, allowing for earlier mobilization and more aggressive early rehabilitation. The potential clinical effect of additional tightening in the superoinferior direction beyond that of the native joint remains an issue for further study.