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Surgical treatment of thoracic outlet syndrome in young adults: single centre experience with minimum three-year follow-up

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Abstract

Thoracic outlet syndrome is an often misdiagnosed syndrome which consists of a neurovascular compression at the upper thoracic outlet. The clinical presentation can be variable, ranging from mild symptoms to venous thrombosis and muscle atrophy. Many aetiologies, both congenital and acquired, related either to bony or soft tissue anomalies, have been associated with this syndrome. As a consequence, the diagnosis is often challenging and sometimes it can be obtained only with surgical exploration. Additionally, no specific clinical test is considered diagnostic of thoracic outlet syndrome. However, the recent advances in imaging techniques together with a careful clinical evaluation give the surgeon the chance to recognize the constricting anatomy before surgery in many cases. No standard surgical procedure has been identified; however, in literature the largest series have been treated with transaxillary first rib resection. Here we report our experience in the surgical treatment of this syndrome with a minimum follow-up of three years. Our approach consists of performing a supraclavicular decompression without routine first rib resection. This allows for identifying and removing the constricting anatomy in most cases, with satisfactory results in 96.9% of patients and a low complication rate.

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Authors and Affiliations

  1. Department of Orthopaedics and Traumatology, San Raffaele Scientific Institute, Via Olgettina 60, 20132, Milan, Italy

    Pietro Ciampi, Celeste Scotti, Gianfranco Fraschini & Giuseppe M. Peretti

  2. Department of Neuroradiology, San Raffaele Scientific Institute, Via Olgettina 60, 20132, Milan, Italy

    Simonetta Gerevini

  3. Department of Radiology, San Raffaele Scientific Institute, Via Olgettina 60, 20132, Milan, Italy

    Francesco De Cobelli

  4. Department of Vascular Surgery, San Raffaele Scientific Institute, Via Olgettina 60, 20132, Milan, Italy

    Roberto Chiesa

  5. Faculty of Exercise Sciences, University of Milan, Via Kramer 4/A, 20129, Milan, Italy

    Giuseppe M. Peretti

Authors
  1. Pietro Ciampi
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  2. Celeste Scotti
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  3. Simonetta Gerevini
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  4. Francesco De Cobelli
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  5. Roberto Chiesa
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  6. Gianfranco Fraschini
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  7. Giuseppe M. Peretti
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Corresponding authors

Correspondence to Gianfranco Fraschini or Giuseppe M. Peretti.

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Ciampi, P., Scotti, C., Gerevini, S. et al. Surgical treatment of thoracic outlet syndrome in young adults: single centre experience with minimum three-year follow-up. International Orthopaedics (SICOT) 35, 1179–1186 (2011). https://doi.org/10.1007/s00264-010-1179-1

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  • DOI: https://doi.org/10.1007/s00264-010-1179-1

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