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Ruy Garcia Marques - One of the best experts on this subject based on the ideXlab platform.
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functional and volumetric analysis of the Pectoralis Major Muscle after submuscular breast augmentation
Aesthetic Surgery Journal, 2017Co-Authors: Ana Claudia Weck Roxo, Fabio Xerfan Nahas, Nadia Cristina Pinheiro Rodrigues, Jose Inacio Salles, Victor Rodrigues Amaral Cossich, Claudio Cardoso De Castro, Jose Horacio Aboudib, Ruy Garcia MarquesAbstract:Background: Dual plane breast augmentation is a technical variation of the submuscular plane described as a technique that reduces contour deformities due to contraction of the Pectoralis Major Muscle and lower risk of double-bubble deformity associated with breast ptosis. Despite improvement in the aesthetic aspect, there is still no consensus whether this technique affects the function of the Pectoralis Major Muscle. Objectives: The aim of this study was to correlate functional with volumetric changes associated with dissection of the Muscle origin in submuscular breast augmentation. Methods: Thirty women who desired to undergo breast augmentation were selected prospectively and randomly allocated to 2 groups: 10 patients in the control group and 20 patients in the interventional group, who underwent submuscular breast augmentation. Magnetic resonance imaging and volumetric software were used to assess Muscle volume and isokinetic dynamometry was used to assess function of the Pectoralis Major Muscle. Preoperative measurements were compared with those at 3, 6, and 12 months after surgery. Results: Magnetic resonance imaging revealed significant decrease in Muscle volume at 6 and 12 months follow-up. The isokinetic test conducted during adduction showed a significant difference in Muscle strength between groups from baseline to the 12-month follow-up, and between the 3- and 12-month follow-up. No significant differences in Muscle strength during abduction were observed from baseline to the 3-, 6-, and 12-month follow-up. Conclusions: Submuscular breast augmentation reduced Muscle strength during adduction 12 months after surgery, but without a significant correlation with volumetric Muscle loss.
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functional and volumetric analysis of the Pectoralis Major Muscle after submuscular breast augmentation
Aesthetic Surgery Journal, 2017Co-Authors: Ana Claudia Weck Roxo, Fabio Xerfan Nahas, Nadia Cristina Pinheiro Rodrigues, Jose Inacio Salles, Victor Rodrigues Amaral Cossich, Claudio Cardoso De Castro, Jose Horacio Aboudib, Ruy Garcia MarquesAbstract:Background Dual plane breast augmentation is a technical variation of the submuscular plane described as a technique that reduces contour deformities due to contraction of the Pectoralis Major Muscle and lower risk of double-bubble deformity associated with breast ptosis. Despite improvement in the aesthetic aspect, there is still no consensus whether this technique affects the function of the Pectoralis Major Muscle. Objectives The aim of this study was to correlate functional with volumetric changes associated with dissection of the Muscle origin in submuscular breast augmentation. Methods Thirty women who desired to undergo breast augmentation were selected prospectively and randomly allocated to 2 groups: 10 patients in the control group and 20 patients in the interventional group, who underwent submuscular breast augmentation. Magnetic resonance imaging and volumetric software were used to assess Muscle volume and isokinetic dynamometry was used to assess function of the Pectoralis Major Muscle. Preoperative measurements were compared with those at 3, 6, and 12 months after surgery. Results Magnetic resonance imaging revealed significant decrease in Muscle volume at 6 and 12 months follow-up. The isokinetic test conducted during adduction showed a significant difference in Muscle strength between groups from baseline to the 12-month follow-up, and between the 3- and 12-month follow-up. No significant differences in Muscle strength during abduction were observed from baseline to the 3-, 6-, and 12-month follow-up. Conclusions Submuscular breast augmentation reduced Muscle strength during adduction 12 months after surgery, but without a significant correlation with volumetric Muscle loss. Level of Evidence 2
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volumetric evaluation of the mammary gland and Pectoralis Major Muscle following subglandular and submuscular breast augmentation
Plastic and Reconstructive Surgery, 2016Co-Authors: Ana Claudia Weck Roxo, Fabio Xerfan Nahas, Claudio Cardoso De Castro, Jose Horacio Aboudib, Renan Salin, Ruy Garcia MarquesAbstract:Background Besides being a procedure with high level of patient satisfaction, one of the main causes for reoperation after breast augmentation is related to contour deformities and changes in breast volume. Few objective data are available on postoperative volumetric analysis following breast augmentation. The aim of this study was to evaluate volume changes in the breast parenchyma and Pectoralis Major Muscle after breast augmentation with the placement of silicone implants in the subglandular and submuscular planes. Methods Fifty-eight women were randomly allocated either to the subglandular group (n = 24) or submuscular group (n = 24) and underwent breast augmentation in the subglandular or submuscular plane, respectively, or to a control group (n = 10) and received no intervention. Volumetric magnetic resonance imaging was performed at inclusion in all participants and either after 6 and 12 months in the control group or at 6 and 12 months after surgery in the intervention groups. Results Twelve months after breast augmentation, only the subglandular group had a significant reduction in glandular volume (mean, 22.8 percent), while patients in the submuscular group were the only ones showing significant reduction in Muscle volume (mean, 49.80 percent). Conclusions Atrophy of the breast parenchyma occurred after subglandular breast augmentation, but not following submuscular breast augmentation. In contrast, submuscular breast augmentation caused atrophy of the Pectoralis Major Muscle. Clinical question/level of evidence Therapeutic, II.
Walter Manna Albertoni - One of the best experts on this subject based on the ideXlab platform.
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Pectoralis Major Muscle Rupture in Athletes A Prospective Study
The American journal of sports medicine, 2009Co-Authors: Alberto De Castro Pochini, Carlos Vicente Andreoli, Gustavo Cará Monteiro, Benno Ejnisman, Moises Cohen, Antonio Carlos Da Silva, Walter Manna AlbertoniAbstract:BackgroundIn the past 20 years, there has been an increase in the incidence of upper extremity tendinous injuries, especially in sports including strong physical activity, such as in weight lifting, as well as with the concurrent use of anabolic steroids. Today, there are more than 200 cases describing rupture of the Pectoralis Major Muscle in athletes.HypothesisSurgical treatment will have a better outcome than nonsurgical treatment in total rupture of the Pectoralis Major Muscle in athletes.Study DesignCohort study; Level of evidence, 2.MethodsTwenty athletes with Pectoralis Major Muscle (PMM) rupture were studied; 10 had surgical treatment, and the other 10 were treated nonoperatively. The mean age was 32.27 years (range, 27-47 years); all of them were men. The average follow-up was 36 months (range, 48-72 months). Injuries were diagnosed by history, physical examination, and subsidiary tests. Functional evaluation and isokinetic evaluation were performed on all 20 patients.ResultsThe clinical evaluati...
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Exact moment of tendon of Pectoralis Major Muscle rupture captured on video
British Journal of Sports Medicine, 2007Co-Authors: Alberto Castro Pochini, Anna Maria Fleury, Carlos Vicente Andreoli, Gustavo Cará Monteiro, Benno Ejnisman, Moises Cohen, Flávio Faloppa, Walter Manna AlbertoniAbstract:A powerlifting athlete ruptured his left tendon of the Pectoralis Major Muscle while attempting to lift 160 kg in a Brazilian bench press championship. The injury seemed to occur in the concentric phase of exercise; however, the more common mechanism of rupture is during the eccentric phase. The tendon was reinserted to the humerus 3 weeks later with screws and washers. The athlete returned to competitive activities after 5 months. One year later he lifted 170 kg and won the national championship.
Benno Ejnisman - One of the best experts on this subject based on the ideXlab platform.
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Surgical treatment of Pectoralis Major Muscle rupture with adjustable cortical button
Revista brasileira de ortopedia, 2017Co-Authors: Alberto De Castro Pochini, Carlos Vicente Andreoli, Marcus De Souza Barbosa Rodrigues, Larissa Yamashita, Paulo Santoro Belangero, Benno EjnismanAbstract:Abstract Objective To assess the tendon reconstruction technique for total rupture of the Pectoralis Major Muscle using an adjustable cortical button. Methods Prospective study of 27 male patients with a mean age of 29.9 (SD = 5.3 years) and follow-up of 2.3 years. The procedure consisted of autologous grafts taken from the semitendinosus and gracilis tendons and an adjustable cortical button. Patients were evaluated functionally by the Bak criteria. Results The surgical treatment of Pectoralis Major Muscle tendon reconstruction was performed in the early stages (three weeks) in six patients (22.2%) and in 21 patients (77.8%), in the late stages. Patients operated with the adjustable cortical button technique obtained 96.3% excellent or good results, with only 3.7% having poor results (Bak criteria). Of the total, 85.2% were injured while performing bench press exercises and 14.8%, during the practice of Brazilian jiu-jitsu or wrestling. All weight-lifting athletes had history of anabolic steroid use. Conclusion The early or delayed reconstruction of ruptured Pectoralis Major Muscle tendons with considerable Muscle retraction, using an adjustable cortical button and autologous knee flexor grafts, showed a high rate of good results.
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Surgical repair of a rupture of the Pectoralis Major Muscle
BMJ case reports, 2015Co-Authors: Alberto De Castro Pochini, Carlos Vicente Andreoli, Benno Ejnisman, Nicola MaffulliAbstract:Muscle rupture is rarely treated surgically. Few reports of good outcomes after muscular suture have been published. Usually, muscular lesions or partial ruptures heal with few side effects or result in total recovery. We report a case of an athlete who was treated surgically to repair a total muscular rupture in the Pectoralis Major Muscle. After 6 months, the athlete returned to competitive practice. After a 2-year follow-up, the athlete still competes in skateboard championships.
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clinical considerations for the surgical treatment of Pectoralis Major Muscle ruptures based on 60 cases a prospective study and literature review
American Journal of Sports Medicine, 2014Co-Authors: Alberto De Castro Pochini, Carlos Vicente Andreoli, Moises Cohen, Paulo Santoro Belangero, Marilia Santos Andrade, Eduardo Antonio De Figueiredo, Bernardo Barcellos Terra, Carina Cohen, Benno EjnismanAbstract:Background:Early recognition of the clinical signs of ruptures of the Pectoralis Major Muscle (PMM) in athletes by orthopaedic surgeons, physical therapists, and physical trainers may prove to be critical for patient access to surgical treatment while the injury is still in the acute phase.Hypothesis:Total ruptures of the PMM may yield a better outcome with surgical treatment than with nonoperative treatment in athletes.Study Design:Cohort study; Level of evidence, 2.Methods:A prospective study was performed on 60 patients with total ruptures of the PMM. The patients were followed from 1997 to 2012, with a physical examination every 6 months for the first 2 years and every 12 months thereafter. The patients’ mean age was 31.21 years, and the mean length of follow-up was 48.25 months. The surgical treatment methods included reinsertion of the tendon in 51% of the patients and nonoperative treatment in 49% of the patients. All of the patients were evaluated using the Bak criteria.Results:The bench-press exe...
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isokinetic Muscle assessment after treatment of Pectoralis Major Muscle rupture using surgical or non surgical procedures
Clinics, 2011Co-Authors: Anna Maria Fleury, Benno Ejnisman, Alberto De Castro Pochini, Antonio Carlos Da Silva, Claudio Andre Barbosa De Lira, Marilia Santos AndradeAbstract:INTRODUCTION: Rupture of the Pectoralis Major Muscle appears to be increasing in athletes. However, the optimal treatment strategy has not yet been established. OBJECTIVES: To compare the isokinetic shoulder performance after surgical treatment to that after non-surgical treatment for Pectoralis Major Muscle rupture. METHODS: We assessed 33 Pectoralis Major Muscle ruptures (18 treated non-surgically and 15 treated surgically). Horizontal abduction and adduction as well as external and internal rotation at 60 and 120 degrees/s were tested in both upper limbs. Peak torque, total work, contralateral deficiency, and the peak torque agonist-to-antagonist ratio were measured. RESULTS: Contralateral muscular deficiency did not differ between the surgical and non-surgical treatment modalities. However, the surgical group presented twice the number of athletes with clinically acceptable contralateral deficiency (<20%) for internal rotators compared to the non-surgical group. The peak torque ratio between the external and internal rotator Muscles revealed a similar deficit of the external rotation in both groups and on both sides (surgical, 61.60% and 57.80% and non-surgical, 62.06% and 54.06%, for the dominant and non-dominant sides, respectively). The peak torque ratio revealed that the horizontal adduction Muscles on the injured side showed similar weakness in both groups (surgical, 86.27%; non-surgical, 98.61%). CONCLUSIONS: This study included the largest single series of athletes reported to date for this type of injury. A comparative analysis of muscular strength and balance showed no differences between the treatment modalities for Pectoralis Major Muscle rupture. However, the number of significant clinical deficiencies was lower in the surgical group than in the non-surgical group, and both treatment modalities require greater attention to the rehabilitation process, especially for the recovery of Muscle strength and balance.
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Pectoralis Major Muscle Rupture in Athletes A Prospective Study
The American journal of sports medicine, 2009Co-Authors: Alberto De Castro Pochini, Carlos Vicente Andreoli, Gustavo Cará Monteiro, Benno Ejnisman, Moises Cohen, Antonio Carlos Da Silva, Walter Manna AlbertoniAbstract:BackgroundIn the past 20 years, there has been an increase in the incidence of upper extremity tendinous injuries, especially in sports including strong physical activity, such as in weight lifting, as well as with the concurrent use of anabolic steroids. Today, there are more than 200 cases describing rupture of the Pectoralis Major Muscle in athletes.HypothesisSurgical treatment will have a better outcome than nonsurgical treatment in total rupture of the Pectoralis Major Muscle in athletes.Study DesignCohort study; Level of evidence, 2.MethodsTwenty athletes with Pectoralis Major Muscle (PMM) rupture were studied; 10 had surgical treatment, and the other 10 were treated nonoperatively. The mean age was 32.27 years (range, 27-47 years); all of them were men. The average follow-up was 36 months (range, 48-72 months). Injuries were diagnosed by history, physical examination, and subsidiary tests. Functional evaluation and isokinetic evaluation were performed on all 20 patients.ResultsThe clinical evaluati...
Ana Claudia Weck Roxo - One of the best experts on this subject based on the ideXlab platform.
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functional and volumetric analysis of the Pectoralis Major Muscle after submuscular breast augmentation
Aesthetic Surgery Journal, 2017Co-Authors: Ana Claudia Weck Roxo, Fabio Xerfan Nahas, Nadia Cristina Pinheiro Rodrigues, Jose Inacio Salles, Victor Rodrigues Amaral Cossich, Claudio Cardoso De Castro, Jose Horacio Aboudib, Ruy Garcia MarquesAbstract:Background: Dual plane breast augmentation is a technical variation of the submuscular plane described as a technique that reduces contour deformities due to contraction of the Pectoralis Major Muscle and lower risk of double-bubble deformity associated with breast ptosis. Despite improvement in the aesthetic aspect, there is still no consensus whether this technique affects the function of the Pectoralis Major Muscle. Objectives: The aim of this study was to correlate functional with volumetric changes associated with dissection of the Muscle origin in submuscular breast augmentation. Methods: Thirty women who desired to undergo breast augmentation were selected prospectively and randomly allocated to 2 groups: 10 patients in the control group and 20 patients in the interventional group, who underwent submuscular breast augmentation. Magnetic resonance imaging and volumetric software were used to assess Muscle volume and isokinetic dynamometry was used to assess function of the Pectoralis Major Muscle. Preoperative measurements were compared with those at 3, 6, and 12 months after surgery. Results: Magnetic resonance imaging revealed significant decrease in Muscle volume at 6 and 12 months follow-up. The isokinetic test conducted during adduction showed a significant difference in Muscle strength between groups from baseline to the 12-month follow-up, and between the 3- and 12-month follow-up. No significant differences in Muscle strength during abduction were observed from baseline to the 3-, 6-, and 12-month follow-up. Conclusions: Submuscular breast augmentation reduced Muscle strength during adduction 12 months after surgery, but without a significant correlation with volumetric Muscle loss.
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functional and volumetric analysis of the Pectoralis Major Muscle after submuscular breast augmentation
Aesthetic Surgery Journal, 2017Co-Authors: Ana Claudia Weck Roxo, Fabio Xerfan Nahas, Nadia Cristina Pinheiro Rodrigues, Jose Inacio Salles, Victor Rodrigues Amaral Cossich, Claudio Cardoso De Castro, Jose Horacio Aboudib, Ruy Garcia MarquesAbstract:Background Dual plane breast augmentation is a technical variation of the submuscular plane described as a technique that reduces contour deformities due to contraction of the Pectoralis Major Muscle and lower risk of double-bubble deformity associated with breast ptosis. Despite improvement in the aesthetic aspect, there is still no consensus whether this technique affects the function of the Pectoralis Major Muscle. Objectives The aim of this study was to correlate functional with volumetric changes associated with dissection of the Muscle origin in submuscular breast augmentation. Methods Thirty women who desired to undergo breast augmentation were selected prospectively and randomly allocated to 2 groups: 10 patients in the control group and 20 patients in the interventional group, who underwent submuscular breast augmentation. Magnetic resonance imaging and volumetric software were used to assess Muscle volume and isokinetic dynamometry was used to assess function of the Pectoralis Major Muscle. Preoperative measurements were compared with those at 3, 6, and 12 months after surgery. Results Magnetic resonance imaging revealed significant decrease in Muscle volume at 6 and 12 months follow-up. The isokinetic test conducted during adduction showed a significant difference in Muscle strength between groups from baseline to the 12-month follow-up, and between the 3- and 12-month follow-up. No significant differences in Muscle strength during abduction were observed from baseline to the 3-, 6-, and 12-month follow-up. Conclusions Submuscular breast augmentation reduced Muscle strength during adduction 12 months after surgery, but without a significant correlation with volumetric Muscle loss. Level of Evidence 2
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volumetric evaluation of the mammary gland and Pectoralis Major Muscle following subglandular and submuscular breast augmentation
Plastic and Reconstructive Surgery, 2016Co-Authors: Ana Claudia Weck Roxo, Fabio Xerfan Nahas, Claudio Cardoso De Castro, Jose Horacio Aboudib, Renan Salin, Ruy Garcia MarquesAbstract:Background Besides being a procedure with high level of patient satisfaction, one of the main causes for reoperation after breast augmentation is related to contour deformities and changes in breast volume. Few objective data are available on postoperative volumetric analysis following breast augmentation. The aim of this study was to evaluate volume changes in the breast parenchyma and Pectoralis Major Muscle after breast augmentation with the placement of silicone implants in the subglandular and submuscular planes. Methods Fifty-eight women were randomly allocated either to the subglandular group (n = 24) or submuscular group (n = 24) and underwent breast augmentation in the subglandular or submuscular plane, respectively, or to a control group (n = 10) and received no intervention. Volumetric magnetic resonance imaging was performed at inclusion in all participants and either after 6 and 12 months in the control group or at 6 and 12 months after surgery in the intervention groups. Results Twelve months after breast augmentation, only the subglandular group had a significant reduction in glandular volume (mean, 22.8 percent), while patients in the submuscular group were the only ones showing significant reduction in Muscle volume (mean, 49.80 percent). Conclusions Atrophy of the breast parenchyma occurred after subglandular breast augmentation, but not following submuscular breast augmentation. In contrast, submuscular breast augmentation caused atrophy of the Pectoralis Major Muscle. Clinical question/level of evidence Therapeutic, II.
Carlos Vicente Andreoli - One of the best experts on this subject based on the ideXlab platform.
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Surgical treatment of Pectoralis Major Muscle rupture with adjustable cortical button
Revista brasileira de ortopedia, 2017Co-Authors: Alberto De Castro Pochini, Carlos Vicente Andreoli, Marcus De Souza Barbosa Rodrigues, Larissa Yamashita, Paulo Santoro Belangero, Benno EjnismanAbstract:Abstract Objective To assess the tendon reconstruction technique for total rupture of the Pectoralis Major Muscle using an adjustable cortical button. Methods Prospective study of 27 male patients with a mean age of 29.9 (SD = 5.3 years) and follow-up of 2.3 years. The procedure consisted of autologous grafts taken from the semitendinosus and gracilis tendons and an adjustable cortical button. Patients were evaluated functionally by the Bak criteria. Results The surgical treatment of Pectoralis Major Muscle tendon reconstruction was performed in the early stages (three weeks) in six patients (22.2%) and in 21 patients (77.8%), in the late stages. Patients operated with the adjustable cortical button technique obtained 96.3% excellent or good results, with only 3.7% having poor results (Bak criteria). Of the total, 85.2% were injured while performing bench press exercises and 14.8%, during the practice of Brazilian jiu-jitsu or wrestling. All weight-lifting athletes had history of anabolic steroid use. Conclusion The early or delayed reconstruction of ruptured Pectoralis Major Muscle tendons with considerable Muscle retraction, using an adjustable cortical button and autologous knee flexor grafts, showed a high rate of good results.
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Surgical repair of a rupture of the Pectoralis Major Muscle
BMJ case reports, 2015Co-Authors: Alberto De Castro Pochini, Carlos Vicente Andreoli, Benno Ejnisman, Nicola MaffulliAbstract:Muscle rupture is rarely treated surgically. Few reports of good outcomes after muscular suture have been published. Usually, muscular lesions or partial ruptures heal with few side effects or result in total recovery. We report a case of an athlete who was treated surgically to repair a total muscular rupture in the Pectoralis Major Muscle. After 6 months, the athlete returned to competitive practice. After a 2-year follow-up, the athlete still competes in skateboard championships.
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clinical considerations for the surgical treatment of Pectoralis Major Muscle ruptures based on 60 cases a prospective study and literature review
American Journal of Sports Medicine, 2014Co-Authors: Alberto De Castro Pochini, Carlos Vicente Andreoli, Moises Cohen, Paulo Santoro Belangero, Marilia Santos Andrade, Eduardo Antonio De Figueiredo, Bernardo Barcellos Terra, Carina Cohen, Benno EjnismanAbstract:Background:Early recognition of the clinical signs of ruptures of the Pectoralis Major Muscle (PMM) in athletes by orthopaedic surgeons, physical therapists, and physical trainers may prove to be critical for patient access to surgical treatment while the injury is still in the acute phase.Hypothesis:Total ruptures of the PMM may yield a better outcome with surgical treatment than with nonoperative treatment in athletes.Study Design:Cohort study; Level of evidence, 2.Methods:A prospective study was performed on 60 patients with total ruptures of the PMM. The patients were followed from 1997 to 2012, with a physical examination every 6 months for the first 2 years and every 12 months thereafter. The patients’ mean age was 31.21 years, and the mean length of follow-up was 48.25 months. The surgical treatment methods included reinsertion of the tendon in 51% of the patients and nonoperative treatment in 49% of the patients. All of the patients were evaluated using the Bak criteria.Results:The bench-press exe...
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Pectoralis Major Muscle Rupture in Athletes A Prospective Study
The American journal of sports medicine, 2009Co-Authors: Alberto De Castro Pochini, Carlos Vicente Andreoli, Gustavo Cará Monteiro, Benno Ejnisman, Moises Cohen, Antonio Carlos Da Silva, Walter Manna AlbertoniAbstract:BackgroundIn the past 20 years, there has been an increase in the incidence of upper extremity tendinous injuries, especially in sports including strong physical activity, such as in weight lifting, as well as with the concurrent use of anabolic steroids. Today, there are more than 200 cases describing rupture of the Pectoralis Major Muscle in athletes.HypothesisSurgical treatment will have a better outcome than nonsurgical treatment in total rupture of the Pectoralis Major Muscle in athletes.Study DesignCohort study; Level of evidence, 2.MethodsTwenty athletes with Pectoralis Major Muscle (PMM) rupture were studied; 10 had surgical treatment, and the other 10 were treated nonoperatively. The mean age was 32.27 years (range, 27-47 years); all of them were men. The average follow-up was 36 months (range, 48-72 months). Injuries were diagnosed by history, physical examination, and subsidiary tests. Functional evaluation and isokinetic evaluation were performed on all 20 patients.ResultsThe clinical evaluati...
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Exact moment of tendon of Pectoralis Major Muscle rupture captured on video
British Journal of Sports Medicine, 2007Co-Authors: Alberto Castro Pochini, Anna Maria Fleury, Carlos Vicente Andreoli, Gustavo Cará Monteiro, Benno Ejnisman, Moises Cohen, Flávio Faloppa, Walter Manna AlbertoniAbstract:A powerlifting athlete ruptured his left tendon of the Pectoralis Major Muscle while attempting to lift 160 kg in a Brazilian bench press championship. The injury seemed to occur in the concentric phase of exercise; however, the more common mechanism of rupture is during the eccentric phase. The tendon was reinserted to the humerus 3 weeks later with screws and washers. The athlete returned to competitive activities after 5 months. One year later he lifted 170 kg and won the national championship.