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Thoracic Inlet Syndrome After Surgically Treated Clavicle Fracture.

Elvin Rahimov1, Christian Rudolf Wilhelm Köhler2, Stefan Fischer2

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Zeitschrift Fur Orthopadie Und Unfallchirurgie
|November 7, 2025
PubMed
Summary
This summary is machine-generated.

Screw protrusion after clavicle fracture surgery can cause thoracic inlet syndrome. Prompt surgical intervention, including hematoma evacuation and screw removal, is crucial for restoring blood flow and preventing complications.

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Area of Science:

  • Orthopedic Surgery
  • Vascular Surgery
  • Radiology

Background:

  • Plate osteosynthesis is a common treatment for clavicle shaft fractures.
  • Complications can arise from hardware placement, especially near critical neurovascular structures.
  • Thoracic inlet syndrome can manifest with varied symptoms, including arm paresthesias and discoloration.

Purpose of the Study:

  • To report a rare case of thoracic inlet syndrome secondary to clavicle fracture fixation.
  • To highlight the importance of meticulous screw placement in clavicle osteosynthesis.
  • To discuss the diagnostic and therapeutic approach for neurovascular compression at the thoracic inlet.

Main Methods:

  • A 25-year-old female patient with right arm symptoms post-clavicle fracture surgery.
  • Diagnostic imaging included CT angiography to assess vascular compromise.
  • Surgical management involved hematoma evacuation, first rib resection, and screw revision.

Main Results:

  • CT angiography revealed significant subclavian vein obstruction due to a hematoma and protruding screws.
  • The patient's symptoms resolved after surgical decompression and hardware repositioning.
  • The case underscores the risk of screw protrusion impinging on the subclavicular neurovascular bundle.

Conclusions:

  • Screw protrusion during clavicle osteosynthesis, particularly in the medial third, poses a risk for thoracic inlet syndrome.
  • Early recognition and surgical intervention are vital for managing neurovascular compression in this region.
  • Resection of the first rib can be an effective treatment for severe cases of thoracic inlet syndrome.