Surgical repair of a rare sternal origin pectoralis major rupture using a novel mesh-anchor-suture technique - a case report

Sep 29, 2026

A case report presents a 33-year-old male with a rare, chronic, isolated rupture of the sternal head of the pectoralis major after a combat sport injury. Surgical repair was challenging because chronicity led to significant retraction and poor tissue quality, and only limited literature exists. A novel polypropylene mesh-anchor-suture construct reinserted the muscle to its sternal origin. Recovery was uneventful, restoring near full range of motion and strength by 6 months.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages4

Reading Time10 min

AccessFree to download

Abstract

Keywords

Introduction

Case presentation

Patient description and case history

Clinical findings and imaging approach

Surgical management

Follow-up and outcomes

Immediate postoperative period

Two-week follow-up

Journal of Surgical Case Reports, 2026, 1, rjaf1047 [https://doi.org/10.1093/jscr/rjaf1047](https://doi.org/10.1093/jscr/rjaf1047) Case Report Case Report Surgical repair of a rare sternal origin pectoralis major rupture using a novel mesh-anchor-suture technique: a case report Hafez Saade1 , *, Antoine Saber1 , Firas Al Hassan1 , Jihad Boutrous2 , Joe Abi Akl1 1 Department of Orthopedics and Traumatology, Faculty of Medicine, University of Balamand, Dekwaneh Campus, Rond Point Saloumeh, Dekwaneh, PO Box 55251, Sin El Fil, Lebanon 2 Department of Surgery, Faculty of Medicine, Lebanese University, Rafic Hariri University Campus, Hadath, Baabda District, PO Box 6573/14, Beirut, Lebanon *Corresponding author. Department of Orthopedics and Traumatology, Faculty of Medicine, University of Balamand, Dekwaneh Campus, Rond Point Saloumeh, Dekwaneh, PO Box 55251, Sin El fil, [Lebanon. E-mail:](Lebanon. E-mail: hafez.saade@std.balamand.edu.lb)[ hafez.saade@std.balamand.edu.lb](Lebanon. E-mail: hafez.saade@std.balamand.edu.lb) Abstract In this case report, we present a 33-year-old male patient with a rare, chronic, isolated rupture of the sternal head of the pectoralis major (PM) at its sternal origin following a combat sport injury. Managing this case proved challenging due to the chronicity of the injury, which caused significant retraction and suboptimal tissue quality, and the scarcity of available literature regarding such cases. We employed a novel surgical technique using a polypropylene mesh-anchor-suture construct to reinsert the muscle to its sternal origin. Recovery was uneventful, with restoration of near full range of motion and strength by 6 months post-surgery. Our approach to this case demonstrates the feasibility of surgical repair of rare PM ruptures of sternal origin, even with delayed presentation, using modified surgical techniques. Keywords: pectoralis major rupture; sternal origin; isolated sternal head rupture; repair of pectoralis major; chronic tear with retraction Introduction In 1822, Pâtissier recorded the first case of pectoralis major (PM) rupture; a young boy who sustained the injury while lifting a heavy piece of meat from a hook [1] Although rare, rupture of the PM is becoming more common due to an increased interest in sports, fitness, and weightlifting [2] . These injuries are seen more often in young athletic males [3] . Most PM ruptures involve the tendon near its insertion on the humerus, particularly at themusculotendinous junction or the tendon’s attachment to the bone, in contrast to ruptures at the sternal origin of the muscle which are very rare. Based on current knowledge, cases involving sternal origin ruptures are scarcely reported with fewer than five cases being mentioned in literature. In this review we describe a novel surgical technique used to repair an isolated PM sternal head rupture at its origin at the sternum in a 33-year-old male using a mesh-anchor-suture construct. Case presentation Patient description and case history We present a 33-year-old previously healthy male who visited our clinic for a 2-month history of left PM dysfunction following a combat sports injury. The patient reported sustaining direct trauma to his left chest during training, immediately experiencing sharp pain accompanied by a distinct tearing sensation. Despite recognizing weakness during certain movements, the patient initially attributed these findings to muscle strain. After 2 months of failed conservative management with persistent weakness, the patient sought evaluation at our institution. Clinical findings prompted further evaluation. However, the patient preferred not to undergo MRI and was therefore, asked to undergo a dynamic ultrasound of the PM which showed a subtotal rupture of the sternal head of the PM at the sternal origin (with only a small portion of the distal origin of the muscle intact) with retraction. Immediate surgical repair was recommended bas

FAQs

Who is the patient and what injury pattern is reported?

The report describes a 33-year-old male with a rare, chronic, isolated rupture of the sternal head of the pectoralis major at its sternal origin after a combat sport injury.

Why was management particularly challenging in this case?

Chronicity caused significant retraction and suboptimal tissue quality, and the literature on isolated sternal head ruptures is scarce. The authors also note an 8-month surgical delay.

What surgical technique was used and what outcomes were achieved?

A polypropylene mesh-anchor-suture construct was used to reinsert the muscle to its sternal origin, secured with sutures to the muscle and fascia and anchored to the sternum. Recovery was uneventful, with near full range of motion and strength by 6 months.

Sep 29, 2026

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