Traumatic rupture of the pectoralis major muscle with associated thrombosis of the cephalic vein as part of a seat belt injury following a motor vehicle accident: A case report

Abstract Traumatic rupture of the pectoralis major muscle is a rare concomitant injury in polytrauma patients often resulting in delayed diagnosis. We present the case of a young male patient who, among other injuries, suffered a complete rupture of the right-sided pectoralis major muscle at the humeral insertion point following a motor vehicle accident. Duplex sonography demonstrated an associated thrombosis of the cephalic vein, which was treated initially with intravenous heparin, and long-term with low-molecular weight heparin according to current guidelines. An open refixation of the muscle belly at the humeral insertion point was performed two weeks after the initial trauma. Post-operative follow-up presented a good overall outcome in terms of function and aesthetics. The authors emphasize the need of continuous clinical re-evaluation in the treatment of severely injured patients in order not to overlook relevant injuries.