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Related Concept Videos

The Thoracic Cage: Ribs01:20

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Ribs are curved, flattened bones forming the thoracic cavity wall with the thoracic muscles. There are 12 pairs of thoracic ribs. The posterior ends of all the ribs articulate with the T1–T12 thoracic vertebrae. In contrast,the anterior ends of most ribs attach to the sternum via their costal cartilages.
Parts of a Typical Rib
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Related Experiment Video

Updated: Jan 9, 2026

Transaxillary First Rib Resection for Treatment of the Thoracic Outlet Syndrome
06:57

Transaxillary First Rib Resection for Treatment of the Thoracic Outlet Syndrome

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Transaxillary First Rib Resection in Pediatric Patients with Thoracic Outlet Syndrome.

Jyi Cheng Ng1, Li Ting Tan1, Kai Sheng Khor2

  • 1Department of Surgery, The Johns Hopkins Hospital, Baltimore, MD.

Annals of Vascular Surgery
|December 5, 2025
PubMed
Summary
This summary is machine-generated.

Transaxillary first rib resection (TFRR) effectively treats pediatric thoracic outlet syndrome (TOS), improving symptoms and enabling return to sports. This surgical approach demonstrates high success rates with minimal complications across all TOS types in young patients.

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Area of Science:

  • Pediatric Surgery
  • Vascular Surgery
  • Thoracic Surgery

Background:

  • Thoracic outlet syndrome (TOS) significantly impacts pediatric quality of life, yet surgical data is limited.
  • Transaxillary first rib resection (TFRR) is a key surgical intervention for TOS.

Purpose of the Study:

  • To evaluate the outcomes of TFRR in pediatric patients diagnosed with TOS.
  • To assess the efficacy and safety of TFRR in a young patient cohort.

Main Methods:

  • Retrospective review of pediatric patients (≤18 years) undergoing TFRR for symptomatic TOS.
  • Analysis of treatment approaches and long-term outcomes, including symptom resolution and return to activity.

Main Results:

  • 91 pediatric patients underwent TFRR for neurogenic, venous, arterial, or mixed TOS.
  • High symptomatic improvement rates (97.6% nTOS, 98.0% vTOS) and return to sports (55.2% nTOS, 72.7% vTOS) observed.
  • No major complications reported, indicating a favorable safety profile.

Conclusions:

  • TFRR is a beneficial surgical option for pediatric TOS across all subtypes.
  • The procedure yields high rates of symptomatic improvement and successful return to athletic activities.
  • TFRR in pediatric patients is associated with minimal complications, supporting its clinical utility.