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Updated: May 18, 2026

Transaxillary First Rib Resection for Treatment of the Thoracic Outlet Syndrome
Published on: September 13, 2020
Long thoracic nerve paralysis associated with thoracic outlet syndrome
Y Nakatsuchi1, S Saitoh, M Hosaka
1From the Department of Orthopaedic Surgery, Shinshu University School of Medicine, Matsumoto, Japan.
Abstract:
Two cases of long thoracic nerve palsy associated with thoracic outlet syndrome are reported. Both patients had abnormal posture, with low-set shoulders and winged scapulae. Clinically there was weakness of the serratus anterior muscle with partial denervotion on electromyography. The diagnosis of thoracic outlet syndrome was based on positive vascular tests and brachial plexus nerve compression symptoms induced by the vascular testing positions. An orthosis that held the shoulder in an elevated position was used in both cases. Complete recovery of shoulder function and relief of the symptoms was achieved in both cases at 8 and 13 months, respectively, after application of the orthosis.
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