Outcomes of chronic pectoralis major rupture repair with implant-free Achilles allograft
Bibliographic record
Abstract
Background Pectoralis major tendon (PMT) ruptures are on the rise. Although early surgical repair of PMT ruptures is recommended, some present in a delayed manner, making chronic ruptures more challenging to repair. Although multiple techniques involving different grafts and fixation methods have been described, a standardized approach is lacking. This study aimed to report the clinical outcomes of patients who underwent reconstruction of chronic PMT ruptures using Achilles tendon allograft fixed with implant-free transosseous sutures. Methods A retrospective review of patients who underwent PMT reconstruction with a minimum follow-up of 2 years. Patient demographics, delay in diagnosis and treatment, and follow-up were recorded. Patient-reported outcome measures were recorded at baseline and the final follow-up. These outcomes included the American Shoulder and Elbow Surgeons score, visual analog scale for pain, Constant score, and subjective shoulder value. At the last follow-up, the postoperative ranges of motion and adduction isometric strength were compared with those of the uninjured arm. Additionally, postoperative complications, return-to-previous activities, cosmetic appearance, and overall patient satisfaction were documented. Results Four male patients with a median age of 46.5 years (29-52) were included. The mean delay in diagnosis and treatment was 5.5 months (2-12) and 12 ± 4.9 months, respectively. The overall cohort improved significantly regarding pain (visual analog scale: −6 [95% CI: −2.3 to −9.7], P = .014) and patient-reported outcome measures (American Shoulder and Elbow Surgeons: 23 [95% CI: 14.6-31.4], P = .003; Constant score: 38.8 [95% CI: 9.3-68.2], and P = .025; subjective shoulder value: 45 [95% CI: 0.5-89.5], P = .049). All patients had full range of motion with no differences between the sides (forward flexion: 180° ± 0, external rotation 81° ± 9, and internal rotation: T7 ± 1). The mean adduction strength for the injured side was 21 ± 3.9 kg, with no difference compared to the uninjured side (21 ± 6.7 kg, P = 1). All patients were satisfied and returned to their previous activities; no postoperative complications were reported. Conclusion Chronic PMT rupture reconstruction with Achilles tendon allograft fixed with implant-free transosseous sutures provides excellent clinical outcomes and strength restoration with high satisfaction and low complication rates.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".