• Journal of Society of Preventive Korean Medicine
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• v.17 no.3
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• pp.187-195
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• 2013

Objective : This study was aimed to investigate the effective treatment for patients with thoracic outlet syndrome. Method : This study was carried out to established the clinical criteria of thoracic outlet syndrome. We collected and analyzed the data of patients had come to the GyeonWoo Oriental Medical Clinic after traffic accidents from January 1, 2011 to December 31, 2011. The patients with thoracic outlet syndrome were treated with acupuncture, chuna therapy for 4 weeks. Visual Analog Scale(V.A.S.) was used as the tools determining the effects of oriental medical treatment on neck pain. Result : The treatment of Korean Medicine(KM) including acupuncture, chuna therapy decreased V.A.S. significantly. Conclusion : Acupuncture, chuna therapy were useful treatment for relieving the hand paresthesia due to thoracic outlet syndrome.

• Journal of Chest Surgery
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• v.21 no.3
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• pp.563-566
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• 1988

Thoracic outlet syndrome refers to compression of the subclavian vessels and brachial plexus at the superior aperture of the thorax. it was previously designated according to presumable etiologies such as scalenus anticus, costoclavicular, hyperabduction, cervical rib and first thoracic rib syndromes. We experienced a case of thoracic outlet syndrome[costoclavicular syndrome] which was caused by posttraumatic left clavicular fracture. Patient had suffered from swelling and cyanosis of left forearm and hand. preoperative vascular doppler test, angiography and venography were performed. First rib resection was done with transaxillary approach. After operation preoperative cyanosis and swelling of left forearm and hand were disappeared. Postoperative course was uneventful.

• Journal of Korean Neurosurgical Society
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• v.30 no.12
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• pp.1443-1448
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• 2001

The authors report a case of thoracic outlet syndrome in left side. Thoracic outlet syndrome is a collective term in which symptoms and signs are due to bony and soft tissue compression of the neurovascular bundle at the thoracic outlet. It is a rare case in neurosurgical field. So we had experienced one case of thoracic outlet syndrome which was improved by transaxillary approach for resection of first rib. The clinical features, diagnostic test, radiological findings, and operative technique are presented with review of literatures.

• Journal of Chest Surgery
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• v.25 no.12
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• pp.1497-1501
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• 1992

Acute arterial thromboembolism of the upper extremity associated with the thoracic outlet syndrome differs in many ways from a cardiogenic embolism, particularly in its pathophysiology and management. The neurovascular manifestations have been attributed to a number of separate entities, the main ones being the cervical rib, scalenus anticus, costoclavicular, and hyperabduction syndromes. Recently we experienced a case of acute subclavian artery thromboembolism due to thoracic outlet syndrome and achieved excellent results by surgical treatment. During 3-month follow up periods there was no evidence of recurrence or complications.

• The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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• v.3 no.1
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• pp.17-27
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• 1997

The PT program provides relief to most patients with symptom of TOS. So the purpose of our study is to evaluate a effects of PT program in patients with TOS. PT program included orthopaedic manual therapy with the aim of restoring the function of the upper thoracic aperture is to be recommended, and long-term following is advisable. 1. Mean treatment duration was over an 11.4 day(range 4~24). 2. At the follow-up evaluation, 88.1% of the patients were satisfied with the effects of their therapy. 3. 73% of the patients returened to work after PT and 88% of the patients carried through the recommendations given at discharge during follow up. 4. Normalized grip strength and Tinel' sign predicted patient satisfaction(p< .001) and return to work(p< .001). 5. Return to work was more often successful if the work was sedentary rather than heavy (p< .05).

• Physical Therapy Korea
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• v.13 no.2
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• pp.43-51
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• 2006

The term thoracic outlet syndrome (TOS) is used to describe patients with compressed subclavian arteries, veins, and brachial plexuses in the region of the thoracic outlet. The objective of this study was to evaluate a scalenus stretching exercise that aims to restore normal function to patients with TOS. This study consisted of 60 patients with symptoms of TOS, and divided the patients into 3 groups: one that received manual therapy, one that practiced self stretching, and a control group. Each group consisted of 20 patients. This study assessed the efficacy of scalenus stretching exercise by examining the resting pain, tenderness, spherical grip power, and pinch grip power of patients. The data were analyzed using one-way ANOVA, Scheffe post hoc test, and independent t-test. The results showed that resting pain was statistically significant within the manual therapy and self stretching groups (p<.05), and that the resting pain of the manual therapy group was more statistically significant than that of the self stretching group (p<.05). Tenderness, spherical grip power, and pinch grip were statistically significant within the manual therapy and self stretching groups (p<.05), but there was no statistically significant difference between the two groups (p>.05). Finally I could see that there were no statistical differences between manual therapy and self stretching to improve the symptoms of the patients with TOS. These results imply that self stretching by patients is as important as manual therapy by a physical therapist.

• Archives of Reconstructive Microsurgery
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• v.8 no.1
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• pp.1-9
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• 1999

Surgical treatment was performed on the 39 cases out of 76 cases of entrapments of the thoracic outlet. The remaining 36 cases of entrapments were treated by conservatively. The operated cases were categorized as follows. They were 34 cases of scalenus anticus syndrome, 1 of cervical rib syndrome, 2 of costoclavicular syndrome, and 2 of hyperabduction syndrome. 1. Scalenus anticus syndrome : Anterior scalenotomy was performed by simple sectioning of the attachment to the first rib. 2. Cervical rib syndrome : Complete decompressive resection of cervical rib sometimes required both anterior and posterior approaches to avoid over-retraction of the brachial plexus. 3. Costoclavicular syndrome : Partial decompressive claviculectomy was undergone instead of conventional total claviculectomy. 4. Hyperabduction syndrome : The resection of coracoid process was performed as well as conventional tenotomy of pectoralis minor muscle to insure free up-and-down moving of neurovascular bundle at the time of hyperabduction. Every diagnostic maneuver was tested at the time of operation to observe whether or not neurovascular decompression including restoration of radial pulse was sufficient. Despite of the postoperative vascular restoration was inmediate, neurogenic symptoms were improved slowly. Because this entity is essentially chronic nerve injnry, its recovery needed a couple of months or several. Although improvement was slow, ultimate results were definite. Complication was not observed.

• The Journal of Korean Physical Therapy
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• v.17 no.2
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• pp.107-125
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• 2005

The term of TOS(thoracic outlet syndrome) is used to describe patients with compressed subclavian artery, subclavian vein, and the brachial plexus in the region of the thoracic outlet. The objective of this study was to evaluate a conservative physical therapy that aims to restore normal function to the upper aperture in patients with TOS. The efficacy of this study which is conservative physical therapy, was assessed by pain, grip power, pinch grip, and satisfaction level of patients. The results were as follow; 1. Pain(VAS) was statistically significant with Group 1 and Group 2(P<0.05), and Group 2 was more statistically significant than Group 1(P<0.05). 2. Spherical grip was statistically significant with Group 1 and Group 2(P<0.05), and Group 2 was more statistically significant than Group 1(P<0.05). 3. Pinch grip was statistically significant with group 1 and Group 2(P<0.05), and Group 2 was more statistical significance than Group 1(P<0.05). 4. Satisfaction level was statistically significant with group 1 and Group 2(P<0.05), and Group 2 was more statistically significant than Group 1(P<0.05).

• Journal of Chest Surgery
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• v.34 no.6
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• pp.511-513
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• 2001

Migration of Steinmann pins into the thoracic cavity is uncommon, but when occurs it can bring devasting consequences. A Sixty-year-old woman had pinning of the right humerus surgical neck fracture. She was not followed up after discharge Two years later, a chest x-ray film and chest CT showed that the pin had migrated to the right hemithorax. The migrated pins were removed with right anterolateral thoracotomy incision without any difficulties.

• Journal of Chest Surgery
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• v.40 no.6 s.275
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• pp.463-466
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• 2007

A 21 year old male patient was admitted for pain, edema and a tingling sensation in his right arm. He underwent venography and an MRI scan, and he was diagnosed with Paget-Schroetter syndrome. Thoracoscopic first rib re-section was performed after failure of thrombolytic therapy, The symptoms were relieved after the operation and he was discharged with warfarin medication. First rib resection is generally performed through the standard transaxillary or supraclavicular route. We report here on a successful thoracoscopic first rib resection.