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Updated: Aug 17, 2026

Transaxillary First Rib Resection for Treatment of the Thoracic Outlet Syndrome
Published on: September 13, 2020
Brachial plexus injuries with causalgia resulting from transaxillary rib resection
Abstract:
In each of four patients with suspected thoracic outlet syndromes, the transaxillary approach to resection of the first thoracic and cervical ribs resulted in severe and permanent damage to the brachial plexus. The most severe sequela was causalgia. Weakness of the hand muscles, sensory deficits, and autonomic dysfunction also occurred. Abuse of narcotic analgesics was common. Two patients suffered severe psychological depressions, with one committing suicide. Current enthusiasm with transaxillary rib resections in cases of thoracic outlet syndrome should be tempered by the possibility of severe and permanent injury to the brachial plexus and intractable causalgia.
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Flail Chest-I
Flail chest is a severe and potentially life-threatening condition characterized by the fracture of three or more adjacent ribs in multiple places. It is most commonly caused by direct impacts and trauma, such as motor vehicle accidents or injuries from a steering wheel impact. It can also occur due to falls in elderly individuals with osteoporosis, or assaults involving sharp objects.
Pathophysiology
The pathophysiology of flail chest is complex, involving fractures of...
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Assessment:
1. Clinical Evaluation:
History:
Pneumothorax-II
Clinical Manifestations:
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