[Thoraco-brachial outlet syndrome]

Under this name are included all the neurovascular disorders of ftthe upper limb caused by compression of the subclavian vessels and the vessels of the brachial plexus. There are three dangerous anatomical regions where trouble can arise: the now of scalene muscles, the costo-clavicular interspace, and the pulley of the smaller pectoral muscle. The clinical manifestations are fairly variable but often indicate the diagnosis. Certain clinical tests, in particular angiography with the arm in hyperabduction contribute towards confirmation. With minor forms of the syndrome rehabilitation should suffice. In other cases the cause of the sompression can be removed by surgery: sectioning of the anterior scalene, suppresion of a cervical rib, and particularly resection of the first rib, as this plays an important role.