Thoracic outlet syndrome is a disorder caused by thoracic outlet compression of the brachial plexus and/or the subclavian vessels. The characteristics of thoracic outlet syndrome are highly variable. Objective tests, such as electrodiagnostic studies, are often unreliable in characterizing thoracic outlet syndrome. The existence of thoracic outlet syndrome as a discrete entity is controversial. Surgeons who accept the existence of thoracic outlet syndrome acknowledge that diagnosis is clinical. The variability and complexity of thoracic outlet syndrome lends itself to mistakes in both diagnosis and surgical treatment.
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Objective: The European Society for Vascular Surgery (ESVS) has developed clinical practice guidelines for the care of patients with vascular trauma with the aim of assisting physicians in selecting the optimal management strategy.
Methods: The guidelines are based on scientific evidence completed with expert opinion. By summarising and evaluating the best available evidence, recommendations for the evaluation and treatment of patients have been formulated.
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Ann Phys Rehabil Med
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Service de Médecine Physique et Réadaptation Locomotrice et Respiratoire, CHU Nantes, Nantes Université, 85 rue Saint Jacques, 44093 Nantes, Cedex 1, France; Service de Médecine du Sport, CHU Nantes, Nantes Université, 85 rue Saint Jacques, 44093 Nantes, Cedex 1, France; Inserm, UMR 1229, RMeS, Regenerative Medicine and Skeleton, ONIRIS, Nantes Université, 1 place Alexis Ricordeau, 44000 Nantes Cedex 1, France; Institut Européen de la Main, Hôpital Kirchberg, 9, rue Edward Steichen, L-254 Luxembourg, Luxembourg; Medical Training Center, Hôpital Kirchberg, L2540 Luxembourg, Luxembourg; Institut Régional de Médecine du Sport (IRMS), 85 rue Saint Jacques, 44093 Nantes, Cedex 1, France. Electronic address:
Neurovascular Complications Associated With Clavicle Fractures: A Report of Three Cases and Recommendations.
Cureus
November 2024
Department of Orthopedics, Royal Berkshire NHS Foundation Trust, Reading, GBR.
Neurovascular complications associated with clavicular shaft fractures can manifest at presentation, develop gradually over time, or potentially be iatrogenically induced. Conducting a thorough neurovascular examination and, when warranted, pursuing further investigation through modalities such as CT angiogram, MRI, and nerve conduction studies (NCS) are crucial for early diagnosis and pre-operative planning. This comprehensive approach enhances patient outcomes by facilitating timely intervention and addressing any underlying neurovascular issues associated with the fracture.
View Article and Find Full Text PDFNeurovascular Complications Following Clavicle Fracture Fixation: Timing, Mechanisms, and Clinical Implications.
Cureus
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Department of Orthopedic Surgery, Rutgers Robert Wood Johnson Medical School, New Brunswick, USA.
This review addresses the neurovascular complications associated with the surgical treatment of clavicle fractures through open reduction and internal fixation (ORIF). Despite being a generally safe procedure, it can lead to severe complications including brachial plexopathy, pseudoaneurysm, arteriovenous fistulas (AVF), deep vein thrombosis (DVTs), and thoracic outlet syndrome (TOS). One significant observation, not often highlighted in previous literature, is that neurovascular complications are more common in cases involving delayed fixation, nonunion, or malunion, compared to those treated acutely.
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Interdiscip Cardiovasc Thorac Surg
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Department of Thoracic Surgery, Cantonal Hospital Lucerne, Lucerne, Switzerland.
A cervical rib is the cause of ∼5% of thoracic outlet syndromes (TOS). We report the case of a patient with arterial TOS due to the presence of a cervical rib, managed by combined thoracoscopic and supraclavicular approach. An 18-year-old female patient presented with symptoms of arterial TOS.
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