Three-anchor repair of acute partial distal pectoralis major rupture in a Jiu-Jitsu athlete: a case report

Abstract

Pectoralis major (PM) tendon tears are uncommon but increasingly reported injuries, particularly among young, active males participating in high-demand sports and weightlifting. Surgical repair is generally recommended for young athletes to optimize strength, function, and cosmesis. We present a 22-year-old male with no significant medical history who sustained an indirect eccentric contraction injury to his right PM tendon during jiu-jitsu training. He experienced acute sharp pain and functional limitation. Initial conservative management with oral analgesics and physical therapy failed, leading to surgical intervention approximately one month post-injury. Preoperative MRI suggested a tear at the humeral insertion, but intraoperative findings confirmed a partial rupture involving the distal fibers of both superior and inferior sternocostal portions. The tendon was repaired using three suture anchors with SutureTape and FiberTape in a Krackow configuration. At 4-week follow-up, the patient demonstrated good motor recovery with satisfactory range of motion and improved quality of life. Secure anatomic reattachment of the PM tendon using three suture anchors achieved stable fixation and restoration of the humeral footprint. This technique is reproducible and effective for partial distal tears in active patients, with favorable early clinical outcomes