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Pectoralis Major Allograft Reconstruction

History:

I was into weight training and bodybuilding from the age of 13, blessed with a natural muscular build I made good progress in my training without the use of anabolic steroids or growth hormones.  At 19 years of age I joined the British Army although I continued to train with weights the direction of my fitness training was dictated by the Army for 12 years.

I left the Army didn't train much and piled on 4 stone through poor diet and a lack of exercise.  In July 2007 I joined a gym with the intention of getting myself back into shape and getting fit.  I ate a low carbohydrate diet and trained regularly steadily loosing weight and gaining strength at the gym.  I lost four stone between July 2007 & May 2008 and increased my bench press from 75kg for 10 reps to 110kg for 10 reps between February 2008 and May 2008.  Things were going extremely well I was happy with the results I was getting and people were starting to notice my weight loss and improved body tone.

Injury:

One day I went to the gym to train chest shoulders and triceps.  I warmed up on a cross trainer for 20 minutes then moved on to stretching exercise before starting my chest work out on the smith machine.

I pyramided my weights upwards to give my muscle and connective tissues chance to warm up to avoid injury.

Set 1 = Lots of reps with just the resistance of the smith machine no weights.
Set 2 = 40kgs -10 reps
Set 3 = 50kgs -10 reps
Set 4 = 60kgs - 10 reps
Set 5 = 80kgs - 10 reps
Set 6 = 90kgs - 10 reps
Set 7 = 100kgs - 9 reps
Set 8 = 110kgs - 6 reps.

Although this looks like a lot of sets most of them are warm ups.

However, on set 8 I had done 6 reps and attempted a 7th rep taking the bar down to my chest which was fine.  Upon lifting the bar from my chest I reached the half way point of the exercise and felt a tearing sensation between my chest and my right arm.  I had to take the bar back down a few inches at this time to lock the weights off safely, this caused more tearing and pain.  I knew instantly that I had sustained a serious muscle/tendon injury.

Initial Treatment:

I went to A & E and saw a doctor there he examined me and advised me to take some brufen and paracetamol and go home.  This didn't seem the right action to take at all.  I am a healthcare professional and knew there was something seriously wrong. 

This next day the pain continued and I noticed a lot of bruising on my chest and right arm (I mean it was black and blue).  The following week I returned to work and showed one of the doctors I work with my pec muscle injury. He estimated that I had damaged 70 - 80% of my pec muscle fibres, and advised me not to work.  I went to my GP and pressed her hard to convince her to call an orthopaedic specialist at the local hospital.  The orthopaedic specialist said I didn't need any ultrasound investigation and I definitely didn't need surgery.  I knew this was wrong! 

I took a picture of my injury and sent it to my sister by text message to get her opinion, she is a physiotherapist.  She showed my picture to her colleagues, thankfully one of them suggested I contact Lennard Funk for advice on my injury.

Treatment:

When I was Lennard Funk took a detailed history and examined me, he confirmed that I had fully ruptured the sternal and clavicular heads of my pectoralis major muscle.  I was unable to work and also unable to train. After some discussion I decided to have surgery to repair my pectoralis major muscle injury.

It had taken many months between me asking for help at A&E and my GP and then being referred to Lennard Funk at Wrightington.  During this time my tendon retracted significantly making a direct repair impossible as I had approximately 8 cm of tendon missing between my pec tendon stub and my right arm.  We needed something to bridge the gap here to make the impossible possible.  Lennard Funk suggested that he could use a piece of Achilles tendon allograft from a cadaver to bridge the gap and then just do a direct repair of the new tendon to my humerus with three titanium bone anchors.  He chose the Achilles tendon because it is the strongest tendon in the human body and the processes of disinfection and sterilisation allograft go through before they are implanted into a patient. 

Surgery:

Seven months after the injury, I went into hospital and had the allograft pectoralis major tendon repair surgery.  The operation has been a complete success and although my shoulder was uncomfortable after surgery, I felt comfortable wearing a sling 24 hours a days 7 days a week because I knew it was only a matter of time before my symptoms improved. 

Recovery:

At 7 weeks post surgery I was able to swim 10 lengths breast stroke in a 25 metre pool, a great achievement something I had not been able to do since my injury in May 08.  I am just over 3 months post surgery I can swim 32 lengths breast stroke and bench press 10 reps with a 12kg dumbbell as well a performing most shoulder exercises with some caution when doing pressing movements above my head.  I have 98% mobility in my shoulder and expect to achieve 100% mobility in my shoulder in all ranges very soon.

I am delighted with the outcome of the operation. A few months ago I was looking at having to give up my job as a healthcare professional because I couldn't lift or perform my duties well enough to care for patients.  Now I am looking forward to returning to work in the next couple of months, whilst getting stronger at the gym every day.  In addition I am looking forward to two interview at medical school in the new year with my ambition to become a doctor becoming an ever increasing possibility following a successful surgical repair.


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