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Techniques in Shoulder & Elbow Surgery:
doi: 10.1097/BTE.0b013e31818ff72e
Techniques

Use of Transcutaneous Electrical Nerve Stimulation for Pectoralis Major Tendon Repair

Gwinn, David E. MD; Wilson, Kevin MD; Sracic, Michael K. MD; Hebert, Daniel J. MD

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Abstract

Pectoralis major tears are a rare injury that can lead to significant strength deficits and unacceptable cosmesis. Recent literature on surgical outcomes has consistently shown excellent patient satisfaction and return to function. Delayed repairs, however, can be complicated by tendon retraction and adhesion, which make operative repair difficult and less effective than immediate repair, as reported in some studies. We have found the use of intraoperative transcutaneous electrical nerve stimulation as a safe and quick technical adjunct to define the soft tissue anatomy. By stimulating the muscle, it is possible to assess the degree of tendon adhesion and retraction, which can provide information to safely guide dissection. This technique can also be used for shoulder revision procedures when multiple deltopectoral approaches have scarred and obscured the native anatomical interval.

© 2009 Lippincott Williams & Wilkins, Inc.

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