UNASSIGNED: A single-institution retrospective review was performed on a prospective database of patients with TOS from 2018 to 2023 who had undergone operative decompression for TOS. Demographics, TOS characteristics, predisposing anatomy, operative details, and postoperative outcomes were examined. The primary outcome was postoperative return to sport. Secondary outcomes included vascular patency.
UNASSIGNED: A total of 13 patients who were engaged in high-demand athletic activity at the time of their diagnosis were included. Diagnoses included 8 (62%) patients with venous TOS, 4 (31%) patients with neurogenic TOS, and 1 (8%) patient with arterial TOS. Mixed vascular and neurogenic TOS was observed in 3 (23%) patients. The mean age of the cohort was 30 years. Abnormal scalene structure was observed in 12 (92%) patients, and abnormal bone structures were noted in 4 (27%) patients; 2 (15%) with cervical ribs and 3 (23%) patients with clavicular abnormalities. Prior ipsilateral upper extremity trauma was reported in 4 (27%) patients. Significant joint hypermobility was observed in 8 (62%) patients with a median Beighton score of 6. Supraclavicular cervical and/or first rib resection with scalenectomy was performed in all patients. One case of postoperative pneumothorax was treated non-operatively. Ten (77%) patients returned to sport. Duplex ultrasonography showed subclavian vein patency in all 8 patients with venous TOS and wide patency with no drop in perfusion indices in the patient with arterial TOS.
UNASSIGNED: Athletes with TOS who required operative intervention had a high incidence of musculoskeletal aberrations and joint hypermobility. Supraclavicular decompression was associated with a high success rate, with overall good functional outcomes and good likelihood of patients returning to preoperative high-intensity athletics.
■对2018年至2023年接受TOS手术减压的TOS患者的前瞻性数据库进行了单机构回顾性审查。人口统计,TOS特性,诱发解剖学,操作细节,并检查术后结局.主要结果是术后恢复运动。次要结果包括血管通畅。
■共有13名患者在诊断时从事高需求的运动活动。诊断包括8例(62%)静脉TOS患者,4例(31%)神经源性TOS患者,1例(8%)动脉TOS患者。在3例(23%)患者中观察到混合的血管和神经源性TOS。该队列的平均年龄为30岁。在12例(92%)患者中观察到异常的斜角结构,在4例(27%)患者中发现了异常的骨骼结构;2例(15%)患有颈肋骨和3例(23%)患有锁骨异常的患者。4例(27%)患者报告了同侧上肢创伤。在8位(62%)患者中观察到明显的关节过度活动,中位Beighton评分为6。所有患者均进行了锁骨上颈椎和/或第一肋骨切除术,并进行了斜角切除术。术后1例气胸非手术治疗。10名(77%)患者恢复运动。双重超声检查显示,所有8例静脉TOS患者的锁骨下静脉通畅,动脉TOS患者的血流灌注指数没有下降。
■需要手术干预的患有TOS的运动员肌肉骨骼像差和关节活动过度的发生率很高。锁骨上减压术成功率较高,具有总体良好的功能结局,并且患者恢复术前高强度运动的可能性很高。