Thoracic outlet syndrome caused by synostosis of the first and second thoracic ribs: 2 case reports and review of the literature

J Hand Surg Am. 2014 Dec;39(12):2444-7. doi: 10.1016/j.jhsa.2014.08.034. Epub 2014 Oct 11.


We present 2 cases of combined arterial and neurogenic thoracic outlet syndrome triggered by trauma in patients with congenital synostoses of the first and second ribs. These patients were successfully treated with supraclavicular resection of the first and second ribs and scalenectomy. We review these cases and the associated literature on thoracic outlet syndrome and rib synostosis.

Keywords: Brachial plexus; rib fusion; rib synostosis; subclavian; thoracic outlet syndrome.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Adolescent
  • Diagnostic Imaging
  • Female
  • Humans
  • Male
  • Ribs / abnormalities*
  • Ribs / surgery*
  • Synostosis / complications*
  • Synostosis / diagnosis
  • Synostosis / surgery*
  • Thoracic Outlet Syndrome / diagnosis
  • Thoracic Outlet Syndrome / etiology*
  • Thoracic Outlet Syndrome / surgery*
  • Young Adult