Examen clinique des ruptures du muscle grand pectoral Clinical examination of the pectoralis major tears

The pectoralis major tendon tears are rare pathologies but not exceptional and probably under diagnosed. Clinically, severe lesions of the pectoralis major’s tendon can cause conformational changes of the fossa axillaris whose for understanding requires a perfect knowledge of the tendon’s anatomy. Through our three cases experience, we present in this article the detailed methods of the inspection of the pectoralis major and explain the sometimes-surprising modifications of the fossa axillaris’ anterior wall conformation. While traditionally, only total or subtotal tears are considered as surgical, it appears more pertinent to describe total rupture, major partial tears and minor partial tears. As in the majority of tendinous ruptures, the diagnosis is mainly clinical and based primarily on the inspection of the fossa axillaris. A well-conducted inspection, while respecting a delayed time after the event, could help to classify the tears in these three categories without multiplying investigations. This attitude could have significant impacts and facilitate the following management. © 2012 Elsevier Masson SAS. All rights reserved.