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Thoracic outlet syndrome in children
1Division of Orthopaedics, Children's Hospital of Eastern Ontario, University of Ottawa, Canada.
Journal of Pediatric Orthopedics
|July 1, 1996
Summary
Thoracic outlet syndrome in adolescents can be linked to cervical ribs and rapid growth. Conservative treatment or surgical removal of cervical ribs can effectively resolve symptoms in pediatric patients.
Area of Science:
- Pediatric Orthopedics
- Neurology
- Thoracic Surgery
Background:
- Thoracic outlet syndrome (TOS) is rare in children but can emerge during adolescent growth spurts.
- Cervical ribs are a potential contributing factor to TOS in pediatric populations.
- Symptoms include limb aching, tiredness, and paresthesia, often exacerbated by growth.
Purpose of the Study:
- To investigate the presentation and management of thoracic outlet syndrome in pediatric patients.
- To evaluate the efficacy of conservative versus surgical interventions for TOS in adolescents.
- To understand the role of anatomical changes during growth in TOS development.
Main Methods:
- Retrospective case review of four adolescent patients diagnosed with TOS.
- Assessment of symptoms, presence of cervical ribs, and treatment outcomes.
- Comparison of nonoperative management (exercises, postural correction) and surgical intervention (cervical rib excision).
Main Results:
- Two patients with cervical ribs underwent surgical removal, leading to complete symptom resolution.
- Two patients were managed nonoperatively with shoulder-strengthening exercises and postural adjustments, reporting symptom improvement.
- The dynamic nature of the pediatric thoracic outlet anatomy is highlighted.
Conclusions:
- A conservative approach is recommended initially for pediatric TOS to allow for anatomical adaptation during growth.
- Surgical excision of cervical ribs is a beneficial option for persistent or severe symptoms.
- Management should consider the evolving thoracic outlet anatomy in growing adolescents.