Research Paper Title

Case series of pectoralis major rupture requiring operative intervention sustained on the Royal Marines ‘Tarzan’ assault course.

Abstract

The authors present (with intra-operative imaging) four patients who sustained pectoralis major (PM) ruptures on the same piece of equipment of the ‘Tarzan’ assault course at the Commando Training Centre, Royal Marines (CTCRM).

• Recruits jump at running pace, carrying 21 lbs of equipment and a weapon (8 lbs) across a 6-feet gap onto a vertical cargo-net.
• The recruits punch horizontally through the net, before adducting their arm to catch themselves, and all weight, on their axilla.
• All patients presented with immediate pain and reduced function.
• Two had ruptures demonstrated on magnetic resonance imaging, one on an ultrasound scan and one via clinical examination.
• All four patients were found, at operation, to have sustained type IIIE injuries.
• All patients underwent PM repair using a unicortical button fixation and had an uneventful immediate postoperative course.
• Patient 1 left Royal Marines training after the injury (out of choice; not because of failure to rehabilitate).
• All other patients are under active rehabilitation, hoping to return to training.
• Review of 10 years of records at CTCRM reveal no documented PM rupture prior to the first case in October 2013.
• There has been no change to the obstacle or technique used and all patients deny the use of steroids.

Reference

Evans, J., Smith, C. & Guyver, P.M. (2015) Case series of pectoralis major rupture requiring operative intervention sustained on the Royal Marines ‘Tarzan’ assault course. Shoulder & Elbow. 7(3), pp.174-178. doi: 10.1177/1758573214557145. Epub 2015 Oct 31.