Thoracic outlet syndromes |
| |
Affiliation: | 1. Department of Orthopaedics, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan;2. Department of Radiology, Kajiicho Medical Imaging Center, Kyoto, Japan |
| |
Abstract: | Thoracic outlet syndrome (TOS) is no longer considered to be a single entity. The syndromes are venous (V-TOS), arterial (A-TOS) and neurological (N-TOS), but may co-exist. The end stage of VTOS (Paget Schroetter syndrome or effort thrombosis of the subclavian vein) should be recognized early so that younger sportsmen and musicians in particular can be offered the opportunity of thrombolysis, decompression surgery and balloon venoplasty. Most uncomplicated cases of A-TOS and N-TOS can be treated conservatively with posture, diet, physiotherapy advice and reassurance. Complicated arterial TOS, with aneurysm or embolization, should be treated expeditiously by cervical rib excision and arterial reconstruction. Double crush syndromes are relatively common in patients with TOS. It is easier to treat carpal tunnel syndrome than N-TOS. Muscle wasting and pain are an indication for surgery in N-TOS. |
| |
Keywords: | Arterial TOS cervical rib first rib resection neurogenic TOS Paget Schroetter syndrome scalenectomy thoracic outlet syndrome TOS venous TOS |
本文献已被 ScienceDirect 等数据库收录! |
|