Most common rupture is a tendon avulsion, but can be a rupture at the myotendinous junction, bony avulsion, tendon mid substance rupture, or muscle belly tear.
Medial Pectoral nerve entrapment: hypertrophied pectoralis minor can cause wasting and weakness of the inferior sternal portion of the pectoralis major.
Pec Rupture Anatomy. Pec tendon is 5 cm wide, 1 cm long on the anterior surface, and 2.5 cm long on the posterior surface. It consists of an anterior lamina (clavicular head), and a posterior lamina is formed by the sternal head.
Asymmetric bulge in pectoralis major muscle. No rest pain or loss of motion. Pec major function is not necessary for normal shoulder function.
The fascia surrounding the pectoralis major is continuous with the fascia of the brachium and the medial antebrachial septum. This fascia presents as a palpable cord in the axilla and may be mistaken for an intact pectoralis major tendon.
A patient who has had a rupture of the pectoralis muscle may complain of a sharp tearing sensation. When he attempts to rotate his arm inward and toward his chest (adduction and internal rotation), there will be resistance. The shoulder may also be painful and weak. On examination, there will be swelling and bruising, palpable effect and misshapen anterior axillary fold, weakness with adduction and internal rotation.
The pectoralis major may tear or rupture in various parts of the muscle, with the most common being a rupture of the tendon off the humerus bone. Other parts of the muscle where tears may occur are within the muscle belly itself or at the junction of the muscle and tendon ( musculo - tendinous junction). The muscle can also tear off the sternum, but this is quite rare, according to Michele R. Berman, M.D.
Under Injury, muscle, thorax, strain, front wall, it provides code S29.011. Verified in the Tabular, S29.011 is Strain of muscle and tendon on front wall of thorax. This code is not reportable, however, as there is a note at S29 to add the appropriate 7th character. The patient is being actively treated, so "A" (initial encounter) needs to be appended, making it S29.011A.
According to the ICD-10-CM Official Guidelines for Coding and Reporting, an acute traumatic tear or rupture of a muscle or tendon is classified as a strain (think sTrain = tendon/muscle/fascia). A strain may be an overstretched muscle or a partial or complete tear. These types of injuries are found in Chapter 19 Injury, poisoning, and certain other consequences of external causes ( S00-T88 ). Within this category, injury codes are broken down by body part, type of injury, and in some cases, laterality. The episode of care will also need to be reported and assigned as the 7th character to show "A" (initial encounter), "D" (subsequent encounter), or "S" (sequela).
We also need to know that an acute traumatic tear or rupture of a pectoralis major muscle is classified as a strain and not a sprain. Finally, we should assign as many external cause codes as needed to tell the whole story.
A patient who has had a rupture of the pectoralis muscle may complain of a sharp tearing sensation. When he attempts to rotate his arm inward and toward his chest (adduction and internal rotation), there will be resistance. The shoulder may also be painful and weak. On examination, there will be swelling and bruising, palpable effect and misshapen anterior axillary fold, weakness with adduction and internal rotation.
The pectoralis major may tear or rupture in various parts of the muscle, with the most common being a rupture of the tendon off the humerus bone. Other parts of the muscle where tears may occur are within the muscle belly itself or at the junction of the muscle and tendon ( musculo - tendinous junction). The muscle can also tear off the sternum, but this is quite rare, according to Michele R. Berman, M.D.
According to the ICD-10-CM Official Guidelines for Coding and Reporting, an acute traumatic tear or rupture of a muscle or tendon is classified as a strain (think sTrain = tendon/muscle/fascia). A strain may be an overstretched muscle or a partial or complete tear. These types of injuries are found in Chapter 19 Injury, poisoning, and certain other consequences of external causes ( S00-T88 ). Within this category, injury codes are broken down by body part, type of injury, and in some cases, laterality. The episode of care will also need to be reported and assigned as the 7th character to show "A" (initial encounter), "D" (subsequent encounter), or "S" (sequela).