Pectoralis Major Tendon Reconstruction With Achilles Tendon Allografts Utilizing Combined Pulvertaft Weave and Onlay Techniques.

Surgical treatment of chronic pectoralis major tears presents a technical challenge, as injury chronicity may preclude the ability to perform a direct repair. Many techniques have been described to repair an acute pectoralis tendon rupture, including utilization of unicortical buttons within the humeral footprint. In the chronic setting when direct repair is not possible, reconstruction with allograft tissue can restore strength, improve cosmesis, and yield high functional outcomes; however, literature is limited to small case series. We describe a combined Pulvertaft Weave and onlay technique with dual Achilles tendon allograft in the management of an active duty infantryman with a chronic pectoralis major injury.