Pectoralis Major Muscle - Poland's Syndrome

Poland's Syndrome

Poland’s Syndrome is a congenital anomaly in which there is a malformation of the chest causing the pectoralis major on one side of the body to be absent. Other characteristics of this disease are "unilateral shortening of the index, long, and ring fingers, syndactyly of the affected digits, hypoplasia of the hand, and the absence of the sternocostal portion of the ipsilateral pectoralis major muscle". Although the absence of a pectoralis major is not life threatening, it will have an effect on the person with Poland’s Syndrome. Adduction and medial rotation of the arm will be much harder to accomplish without the pectoralis major. The latissimus dorsi and teres major also aid in adduction and medial rotation of the arm, so they may be able to compensate for the lack of extra muscle. However, some patients with Poland’s Syndrome may also be lacking these muscles, which make these actions nearly impossible.

Researchers from the Department of Rehabilitation Medicine at the Yonsei University College of Medicine in Seoul, Korea reported a case of congenital absence of pectoralis major in 1990. According to Kakulas and Adams, pectoralis major is the most frequently congenitally absent muscle. The case involved a 22 year old marine who had asymmetrical configuration of chest wall who had never experienced difficulties performing daily activities, but who experienced difficulties in the military camp. He had difficulty in some training activities especially those such as throwing a grenade or rope climbing. During a surgery performed to correct the sternal depression, it was found that the right pectoralis major was totally absent. However, previous physical exams did not show deficiencies in muscle strength as the right shoulder was good for flexion, adduction, horizontal adduction and internal rotation. Moreover, his pain and touch sensation were normal. X-rays were also performed and showed normal pictures of the chest's bones. The fact that the absence of pectoralis major did not cause functional loss in ordinary activities in this case of congenital absence showed that other surrounding muscles played a compensation role.

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