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Updated: Apr 14, 2026

Transaxillary First Rib Resection for Treatment of the Thoracic Outlet Syndrome

Transaxillary First Rib Resection for Treatment of the Thoracic Outlet Syndrome

Published on: September 13, 2020

Managing pediatric thoracic outlet syndrome.

Aierken Rehemutula^1,2,3, Li Zhang^4,5,6, Lin Chen^7,8,9

¹Department of Hand Surgery, Huashan Hospital, Fudan University, Shanghai, 200040, People's Republic of China. Drarkin@163.com.

Italian Journal of Pediatrics

|April 17, 2015

Summary

Thoracic outlet syndrome (TOS) in children is often missed. Early diagnosis and treatment, including surgery or conservative methods, can lead to improved outcomes and symptom relief for pediatric patients.

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Area of Science:

Pediatric Surgery
Neurology
Orthopedics

Background:

Thoracic outlet syndrome (TOS) is underdiagnosed in pediatric populations.
This condition is not commonly recognized as a pediatric disorder.

Purpose of the Study:

To clarify causes, treatment, and prognosis of TOS in children and adolescents.
To highlight the importance of considering TOS in pediatric patients with specific symptoms.

Main Methods:

Retrospective study of 13 pediatric patients (ages 4-13) with TOS.
Patients received either surgical treatment (10) or conservative management (3).
All patients underwent local nerve blocks and were followed for over 2 years.

Main Results:

Six school-aged children returned to school within 10-14 days post-surgery.
Conservative treatment led to increased limb activity and muscle strength without discomfort.
No significant complications were reported for either treatment group.

Conclusions:

Pediatric TOS should be suspected in children with neck/shoulder discomfort, hand numbness, and upper limb weakness.
A thorough physical examination is crucial for diagnosing pediatric TOS.
Conservative treatment is effective for mild cases and as an alternative to surgery.