A Novel Surgical Technique and Narrative Review for Pectoralis Major Tendon Repair: Integration of Unicortical Button Fixation and DX Reinforcement Matrix Augmentation.

Pectoralis major tendon (PMT) ruptures are increasingly seen in athletes, particularly weightlifters, often requiring surgical repair to restore function. Current surgical techniques may be limited by poor tendon quality or significant retraction. We present a novel approach combining unicortical button fixation with DX Reinforcement Matrix augmentation in a competitive weightlifter with a complete PMT rupture and contralateral pectoralis dysfunction. Intraoperatively, the tendon was augmented with a DX Matrix and fixed using a unicortical button to restore the anatomic footprint and reduce repair tension. The patient underwent structured rehabilitation and returned to full activity within six months. MRI at 12 months showed intact tendon healing at the anatomical footprint without graft failure or retraction. The Oxford Shoulder Score was 48 at six months, indicating high patient satisfaction. This technique is designed to provide a biomechanically robust and biologically supportive solution for complex PMT repairs and may improve outcomes, particularly in high-demand individuals. Further evaluation in larger cohorts is needed.