The Forgotten Pectoralis Minor Syndrome: 100 Operations for Pectoralis Minor Syndrome Alone or Accompanied by Neurogenic Thoracic Outlet Syndrome

Sanders, Richard J.; Rao, Neal

doi:10.1016/j.avsg.2010.02.022

Cited by 66 publications

(109 citation statements)

References 11 publications

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“…Furushima et al reported that subjects with severe TOS have some anatomical abnormalities of the origin and insertion of the scalene muscle, in which variation may cause compression within the interscalene triangle [46]. The other possible reason could be that bilateral hypertrophy of the scalene and pectoralis minor muscles induced by strenuous exercise is often observed in athletes [18] [39] [41]. The subclinical congenital and/or acquired anatomical pathology may be elicited neurovascular symptoms in the athletes when strenuously using their unilateral or bilateral arm in overhead activity.…”

Section: Discussionmentioning

confidence: 99%

“…This condition was first described by Wright in 1945 as "hyperabduction syndrome", in which neurovascular bundle was occluded by the overlying pectoralis minor muscle [16]. Sanders RJ described the several characteristic findings of "neurogenic pectoralis minor syndrome", such as no history of trauma, absent of occipital headache and neck pain, and minimal or no response to the provocative test of TOS [17] [18].…”

Section: Introductionmentioning

confidence: 99%

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The Prevalence and Characteristics of Thoracic Outlet Syndrome in High School Baseball Players

Otoshi¹,

Kikuchi²,

Kato³

et al. 2017

Health

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Thoracic outlet syndrome (TOS) is one of the common neurovascular disorders of the upper extremities, and the compression or traction of the brachial plexus is the main pathology. We hypothesized that baseball players are more likely to be affected by TOS compared with other overhead-throwing athletes because of strenuous use of their throwing arm. The purpose of this study was to investigate the prevalence and clinical characteristics of TOS in high school baseball players. One thousand two hundred eighty-eight high school baseball players were included in this study. The prevalence of symptomatic TOS and its association to disorders of the upper extremities were investigated. The prevalence of symptomatic TOS was 32.8%. Age-and position-adjusted logistic regression analysis revealed that subjects with symptomatic TOS were at significantly higher risk of shoulder and/or elbow pain (odds ratio [OR]: 1.96, 95% confidence interval [CI]: 1.50 -2.58) and a higher recurrence rate of shoulder and/or elbow pain during the previous season (OR: 2.38, 95% CI: 1.87 -3.04). As for physical findings, subjects with symptomatic TOS were also at significantly higher risk of MUCL tenderness (OR: 2.53, 95% CI: 1.83 -3.50), positive milking maneuver, (OR: 2.63, 95% CI: 1.78 -3.91), positive subacromial impingement sign (OR: 1.92, 95% CI: 1.20 -3.07), and positive posterior impingement sign (OR: 2.34, 95% CI: 1.67 -3.28) compared to the subjects without symptomatic TOS. It is necessary to recognize that TOS is not a rare pathology in overhead-throwing athletes, especially baseball players, and that players with symptomatic TOS are at significantly higher risk of shoulder/elbow pain.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

The Prevalence and Characteristics of Thoracic Outlet Syndrome in High School Baseball Players

Otoshi¹,

Kikuchi²,

Kato³

et al. 2017

Health

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“…In a recently published study of patients with PMS, either in isolation or accompanied by neurogenic TOS localized to the supraclavicular scalene triangle, injuries of various types were present in 82 % of patients, whereas PMS developed spontaneously in 18 % (Table 15.1 ) [ 1 ] . The most common type of injury in isolated PMS was an automobile accident, similar to previous observations on the etiology of neurogenic TOS (NTOS).…”

Section: Etiologymentioning

confidence: 98%

“…Pectoralis minor syndrome (PMS) is a subset of neurogenic thoracic outlet syndrome (TOS) that can cause upper extremity symptoms of paresthesias, pain, and/or weakness due to compression of the neurovascular bundle by the pectoralis minor muscle (PM) [ 1 ] . PMS may exist as an isolated condition or in combination with brachial plexus compression at the level of the supraclavicular scalene triangle (PMS + ST).…”

Section: Introductionmentioning

confidence: 99%

Pectoralis Minor Syndrome

Sanders

2013

Thoracic Outlet Syndrome

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Pectoralis minor syndrome (PMS) is a subset of neurogenic thoracic outlet syndrome (TOS) that can cause upper extremity symptoms of pain, paresthesia, and/or weakness due to compression of the neurovascular bundle by the pectoralis minor muscle (PM). The most distinguishing symptoms and signs of PMS include pain and/or tenderness in the subclavicular anterior chest wall and axilla. The clinical diagnosis of PMS can be con fi rmed by an improvement in symptoms and physical fi ndings following a PM muscle block with local anesthetic. Treatment begins with PM stretching exercises. If this is insuf fi cient, PM tenotomy (PMT) is a low risk operation, which can be performed as an outpatient. When PMS is the only diagnosis the success rate of PMT is 90 %, but when PMS is accompanied by nerve compression at the level of the scalene triangle the success rate of isolated PMT is only 35 %. PMS should also be considered in all patients with recurrent neurogenic TOS, as this condition has been found in a substantial proportion of such patients.

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“…Bunlar 1) İnterskalen üçgen, 2) Kosta-klaviküler aralık 3) Retro pektoralis minör aralığıdır. Başlangıçta yapılan çalışmalarda TOS patolojisinde interskalen üçgen üzerine odaklanılmışken, yakın zamanda yapı-lan çalışmalar, TOS olan hastaların yarıdan fazlasının pektoralis minör kompresyonu ile ilişkili olduğunu göstermiştir (1,2). Bu üç dar aralıkta konjenital kemik ve fibromüsküler anormalliği olan hastaların çoğunun asemptomatik olduğu akılda tutulmalıdır.…”

Section: Introductionunclassified

Surgical anatomy of the thoracic outlet

Kaplan¹,

Cömert²

2014

Toraks Cer Bult

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The thoraco-cervico-axillary region is a complex structure consisting of three narrow passages. This region contains three important structures: the subclavian artery and vein and brachial plexus. By definition, Thoracic outlet syndrome (TOS) is hand and arm symptoms of pain, parasthesia and weakness due to compression of the neurovascular bundle in the thoracic outlet area. Three spaces that could be responsible for upper extremity neurovascular compression symptoms are; inter-scalene triangle, costo-clavicular space, retro-pectoralis minor space. Congenital variations in bony and fibro-muscular structures in these areas compounded with trauma, inflammation, wrong posture or dynamic demands of upper extremity predispose to the onset of TOS. Knowledge of anatomy is the key to understanding the pathophysiology of TOS.

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The Forgotten Pectoralis Minor Syndrome: 100 Operations for Pectoralis Minor Syndrome Alone or Accompanied by Neurogenic Thoracic Outlet Syndrome

Cited by 66 publications

References 11 publications

The Prevalence and Characteristics of Thoracic Outlet Syndrome in High School Baseball Players

The Prevalence and Characteristics of Thoracic Outlet Syndrome in High School Baseball Players

Pectoralis Minor Syndrome

Surgical anatomy of the thoracic outlet

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