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Subcoracoid neurovascular entrapment.

D I McIntyre

    Clinical Orthopaedics and Related Research
    |May 1, 1975
    PubMed
    Summary

    This review highlights a specific upper limb syndrome often caused by injury. Surgical decompression of the neurovascular bundle effectively relieved radiating symptoms in most patients.

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    Area of Science:

    • Orthopedic Surgery
    • Neurology
    • Vascular Surgery

    Background:

    • A review of 19 patients with upper limb symptoms, often precipitated by injury, is presented.
    • Patients were typically young adults (22-44 years), with a male predominance.
    • Symptoms included aching pain in the neck, shoulder, arm, and forearm, with intermittent numbness, potentially influenced by posture.

    Purpose of the Study:

    • To describe the clinical presentation and diagnostic findings of a specific upper limb syndrome.
    • To evaluate the effectiveness of conservative and surgical management strategies.

    Main Methods:

    • Clinical review of 19 patients diagnosed with upper limb symptoms.
    • Physical examination focusing on tenderness over the neurovascular bundle.
    • Assessment of diagnostic utility of radiography, electromyography, and venography.
    • Evaluation of outcomes following conservative treatment and surgical decompression (division of pectoralis minor).

    Main Results:

    • Tenderness and symptom reproduction upon palpation of the neurovascular bundle were the most consistent diagnostic findings.
    • Conventional imaging (radiographs) and electrodiagnostic tests (electromyography, venography) showed limited diagnostic value.
    • Conservative measures provided partial symptom relief in some cases.
    • Surgical decompression of the neurovascular bundle in 10 limbs successfully resolved radiating symptoms, with residual mild shoulder pain in 4 instances.

    Conclusions:

    • The described upper limb syndrome is clinically recognizable.
    • Conservative management can alleviate symptoms in approximately half of the cases.
    • Surgical release of the pectoralis minor muscle offers significant relief for well-localized cases.

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