• Archives of Reconstructive Microsurgery
• /
• v.19 no.1
• /
• pp.7-11
• /
• 2010

Interpostion arthroplasty with allograft has been known as a useful option for the shoulder arthropathy, but it has a limitation to immune response. We performed the pectoralis major muscle transfer for shoulder arthropathy. From January 2007 to December 2007, we performed the pectoralis major muscle transfer in 2 patients. They were 1 man and 1 woman, and the mean age of the patients was 70 years (range, 65 to 75). The average follow-up after surgery was 13 months (range, 12 to 14). We analyzed the clinical results by the American Shoulder and Elbow Surgeons (ASES) Score, and evaluated the pain by Visual Analogue Scale. The level of pain reduced from a preoperative average of 10 to a postoperative average of 1. The ASES scores increased from a preoperative mean of 9 to a postoperative mean of 58. These results indicated that interposition arthroplasty with the pectoralis major muscle transfer is a reliable treatment method for the shoulder arthropathy improving shoulder pain, and patient satisfaction.

• Archives of Plastic Surgery
• /
• v.39 no.1
• /
• pp.36-41
• /
• 2012

Background : Poststernotomy mediastinitis is a rare, but life-threatening complication, thus early diagnosis and proper management is essential for poststernotomy mediastinitis. The main treatment for mediastinitis is aggressive debridement. Several options exist for reconstruction of defects after debridement. The efficacy of immediate debridement and reconstruction with a pectoralis major muscle flap designed for the defect immediately after the diagnosis of poststernotomy mediastinitis is demonstrated. Methods : Between September 2009 and June 2011, 6 patients were referred to the Department of Plastic and Reconstructive Surgery and the Department of Thoracic and Cardiovascular Surgery of Ajou University Hospital for poststernotomy mediastinitis. All of the patients underwent extensive debridement and reconstruction with pectoralis major muscle flaps, advanced based on the pedicle of the thoracoacromial artery as soon as possible following diagnosis. A retrospective review of the 6 cases was performed to evaluate infection control, postoperative morbidity, and mortality. Results : All patients had complete wound closures and reduced severity of infections based on the erythrocyte sedimentation rate and C-reactive protein levels and a reduction in poststernal fluid collection on computed tomography an average of 6 days postoperatively. A lack of growth of organisms in the wound culture was demonstrated after 3 weeks. There were no major wound morbidities, such as hematomas, but one minor complication required a skin graft caused by skin flap necrosis. No patient expired after definitive surgery. Conclusions : Immediate debridement and reconstruction using a pectoralis major muscle flap is a safe technique for managing infections associated with poststernotomy mediastinitis, and is associated with minimal morbidity and mortality.

• Journal of Chest Surgery
• /
• v.48 no.4
• /
• pp.258-264
• /
• 2015

Background: This study aimed to evaluate the therapeutic results and safety of pectoralis major muscle turnover flaps in the treatment of mediastinitis after coronary artery bypass grafting (CABG) procedures. Methods: Data regarding 33 patients with post-CABG deep sternal wound infections (DSWIs) who underwent pectoralis major muscle turnover flap procedures in the Emam Reza and Ghaem Hospitals of Mashhad, Iran were reviewed in this study. For each patient, age, sex, hospital stay duration, remission, recurrence, and associated morbidity and mortality were evaluated. Results: Of the 2,447 CABG procedures that were carried out during the time period encompassed by our study, DSWIs occurred in 61 patients (2.5%). Of these 61 patients, 33 patients (nine females [27.3%] and 24 males [72.7%]) with an average age of $63{\pm}4.54$ years underwent pectoralis major muscle turnover flap placement. Symptoms of infection mainly occurred within the first 10 days after surgery (mean, $10.24{\pm}13.62days$). The most common risk factor for DSWIs was obesity (n=16, 48.4%) followed by diabetes mellitus (n=13, 39.4%). Bilateral and unilateral pectoralis major muscle turnover flaps were performed in 20 patients (60.6%) and 13 patients (39.4%), respectively. Complete remission was achieved in 25 patients (75.7%), with no recurrence in the follow-up period. Four patients (12.1%) needed reoperation. The mean hospitalization time was $11.69{\pm}6.516days$. Four patients (12.1%) died during the course of the study: three due to the postoperative complication of respiratory failure and one due to pulmonary thromboembolism. Conclusion: Pectoralis major muscle turnover flaps are an optimal technique in the treatment of post-CABG mediastinitis. In addition to leading to favorable therapeutic results, this flap is associated with minimal morbidity and mortality, as well as a short hospitalization time.

• Journal of the Korean Society of Physical Medicine
• /
• v.12 no.3
• /
• pp.73-77
• /
• 2017

PURPOSE: The present study aimed to measure muscle activities in the pectoralis major, the erector spinae, and the quadriceps femoris according to support surface states of arms and legs during plank exercise. METHODS: The subjects of this study were 21 healthy males in their 20s and their muscle activities at three states were measured as follows: The first state was where the support surface of arms and legs was stable. The second state was where only arms were unstable, and the third state was where only legs were unstable. Electromyography (EMG) was used to measure muscle activities. Pectoralis major, quadriceps femoris, and elector spinae were measured for muscle activities. RESULTS: The muscle activities in the pectoralis major were statistically high when arms were unstable. The muscle activities in the quadriceps femoris were statistically high when legs were unstable. The muscle activities in the erector spinae were higher when arms and legs were unstable compared to that at the stable support surface. No significant difference was revealed statistically when arms and legs were unstable. CONCLUSION: If the instability of arms and legs is employed during plank exercise, exercise on the upper and lower bodies or the erector spinae is expected to be more effective.

• Maxillofacial Plastic and Reconstructive Surgery
• /
• v.23 no.3
• /
• pp.248-253
• /
• 2001

Main disadvantages of conventional pectorails major myocutaneous flap is bulkness of muscular pedicle. It makes difficult to use this flap in a case of supraomohyoid neck dissection. Pectoralis major myocutaneous island flap is a modification to overcome this shortcoming. And bilobular design of skin portion of this flap could be used for reconstruction of a through and through defect. We report a case of reconstruction of full-thickness defect of cheek with bilobular pectoralis major myocutaneous island flap and compare it with conventional pectoralis myocutaneous flap.

• Physical Therapy Rehabilitation Science
• /
• v.12 no.3
• /
• pp.340-345
• /
• 2023

Objective: The purpose of this study was to investigate the effect of thoracic spine and ankle joint alignment on trunk and upper limb muscle activity during trunk forward lean exercise using a sling. Methods: 25 subjects participated in this study. All subjects performed trunk forward lean exercise using a sling under four conditions according to the alignment of the thoracic spine and ankle joints. Trials were performed 3 times in each condition. Muscle activity of the trunk and upper extremity was measured using electromyography. Results: In the dorsiflexion, the thoracic kyphosis condition showed significantly higher muscle activity in the pectoralis major, rectus abdominis, latissimus dorsi, transverse abdominis than dorsiflexion(p<0.05). In the plantar flexion, thoracic kyphosis condition showed significantly higher muscle activity in pectoralis major, transverse abdominis, latissimus dorsi muscle activity than dorsiflexion(p<0.05). Conclusions: Regardless of ankle alignment, thoracic kyphosis condition increased the activity of the pectoralis major, transverse abdominis, latissimus dorsi. Therefore, regardless of the alignment of the ankle, it is recommended to perform the trunk forward lean exercise using a sling in thoracic kyphosis.

• Clinics in Shoulder and Elbow
• /
• v.13 no.1
• /
• pp.123-126
• /
• 2010

Purpose: Poland syndrome is rare disease which is characterized by absence of unilateral pertoralis major muscle accompanied by ipsilateral syndactyly or brachydactyly, which was described first by Alfred Poland in 1841. Materials and Methods: We performed the physical examination, laboratory test and radiologic evaluation to 18 year old male, who complaint asymmetry of right anterior chest. Results: We diagnosed the Poland syndrome due to absence of right pectoralis major muscle and brachydactyly of right hand. Conclusion: Current authors report a patient who had hypopalsia of pectoralis muscles, which needed differential diagnosis with pectoralis major rupture.

• Korean Journal of Applied Biomechanics
• /
• v.14 no.1
• /
• pp.41-50
• /
• 2004

The objective of the study is to analyze the myoelectrical activity involved in performing the Swallow movement, a D-level technique, in order to use it as the basic research data in helping train gymnasts in how to perform strength-related techniques. To this end, four national representative athletes who participated in the 2002 Busan Asian Games were selected. The results of the comparison analysis of the individual models are summarized as follows. 1) The results of the E.M.G analysis showed that during the Swallow movement, the myoelectrical activity was detected higher in pectorialis major muscle and bicep brachii muscle than in trapezius muscle and deltoid muscle. 2) The results of the E.M.G analysis showed that during the Swallow movement, the myoelectrical activity was measured high in triceps brachii muscle and palmaris longus muscle, while the myoelectrical activity was recorded low in latissimus dorsi muscle and rectus abdominis muscle. 3) In performing the Swallow in the rings, the mean average (%) was found high in the order of erector spinae, pectorialis major muscle, palmaris longus muscle, triceps brachii muscle, deltoid muscle, latissimus dorsi muscle, and trapezius muscle. All taken together, the athletes showed a difference in the distribution of the muscles during the performance of the Swallow. The muscle that showed a constant distribution among the athletes was pectoralis major muscle, which proves that for a stable performance, it is ideal to increase the myoelectrical activity in pectoralis major muscle.

• Korean Journal of Applied Biomechanics
• /
• v.18 no.4
• /
• pp.143-149
• /
• 2008

The purpose of this study was to investigate the muscle activities of pectoralis major, upper serratus, lat dorsi, anterior deltoid, rhomboids, infraspinatus, and posterior deltoid using Noraxon 8 channels EMG system during T-ball swing in children with Down syndrome. Five Down syndrome, one healthy children, and one baseball adult player were participated in the study. Down syndrome's children showed higher muscle activity than one healthy children and one baseball adult player during address to backswing and backswing to impact swing phase. While Down syndrome's children showed lower muscle activity than one healthy children and one baseball adult player during impact to follow swing phase. The strength of the pectoralis major and upper serratus muscle may help to improve T-ball swing movement during impact to follow swing phase.

• Physical Therapy Korea
• /
• v.26 no.4
• /
• pp.29-34
• /
• 2019

Background: The serratus anterior is one of the most important muscle for maintaining good scapular alignment in the shoulder joint. The pectoralis major and upper trapezius may also compensate for weak serratus anterior muscles. The push-up plus exercise has been identified as the optimal exercise for maximum activation of the serratus anterior. Objects: The purpose of this study was to examine differences in surface electromyography (EMG) activity of upper trapezius, pectoralis major, and serratus anterior muscles during push-up plus exercises on variously angled surfaces in subjects with winged scapula. Methods: Sixteen subjects with winged scapula (male=5, female=11) volunteered for this study. The subjects performed push-up plus exercise on four different tilt angles, namely $0^{\circ}$, $30^{\circ}$, $60^{\circ}$, and $90^{\circ}$. EMG activities in the serratus anterior, upper trapezius, and pectoralis major muscles during performance of push-up plus exercise were measured in all subjects. Data were processed from repeated measures one-way analysis of variance. Results: There was significant difference in the muscle activity of the serratus anterior on the different surface angles (p<.05). The results of the post-hoc analysis showed significantly greater serratus anterior muscle activity on a surface at a $0^{\circ}$ angle than at others tilt angles (p<.05). There was also significant difference in the ratio of serratus anterior to upper trapezius and serratus anterior to pectoralis major across the four surfaces (p<.05), and post-hoc analysis showed significantly greater values on the $0^{\circ}$ surface than on other tilts (p<.05). Conclusion: This study found that performing push-up plus exercises on a flat surface with $0^{\circ}$ and $30^{\circ}$ tilt angle achieves high activation of the serratus anterior muscle for selective strengthening. It can also take into account the sequential application, which is first performed at a $30^{\circ}$ and at a $0^{\circ}$ tilt angle for and effective but not excessive muscle activation.