[A case of hyperabduction syndrome associated with cervical rib syndrome (author's transl)].
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Two cases are reported of vascular complications in the cervical rib syndrome. In one case thrombosis developed in the distal part of the brachial artery, and in both cases compression of the subclavian artery could be demonstrated clinically and during arteriography. Attention is called to the necessity of surgical treatment of patients with evidence of vascular compression in view of the possibility of thrombotic complications. Coexistence of several causes of compression and the relationship of good therapeutic result to removal of all causes is stressed.
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A series of 38 patients with thoracic outlet syndrome caused by a cervical rib is reviewed after a postoperative follow-up period of 3 to 24 years. The outcome of the operation (anterior scalenotomy and partial to subtotal removal of the cervical rib) is not considered wholly satisfactory; three causes for this were identified: excessive duration of symptoms (mean almost 6 years), insufficient patient work-up and inadequacy of the incomplete removal of the cervical rib. In the presence of a cervical rib, other possible causes of compression of the neurovascular supply to the upper limb should always be considered.
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