Anomalous muscle causes thoracic outlet syndrome (TOS). A 40-year-old man presented with numbness of the left upper extremity, similar to cervical spondylotic radiculopathy. He presented with a positive Bakody\'s test. However, magnetic resonance imaging showed no significant changes in the cervical spine and revealed an anomalous muscle adjacent to the left brachial plexus. We diagnosed the muscle as the cause of TOS and performed a resection, which resulted in symptomatic improvement.

We describe the case of an adult 19 year old male with a fractured right radius. The patient underwent a revision open reduction and internal fixation due to mal-alignment under combined general anaesthesia and supraclavicular brachial plexus block. Postoperatively the patient developed disproportionately intense pain despite an otherwise fully functioning sensory and motor block. The limb was swollen, tender and there was loss of radial pulse. Upon re-exploration a large haematoma was evacuated, a bleeding vessel being the causative factor. There were no further sequellae. The hallmark of this case report is the presence of out-of-proportion pain with an odd distribution in the forearm in the presence of a dense and fully established nerve block. Acute compartment syndrome was diagnosed based on classical signs and symptoms within two hours of block performance. Appropriate treatment lead to satisfactory outcome.
Am descris cazul unui adult în vârstă de 19 ani cu o fractură de radius drept, supus intervenţiei de reducere deschisă a fracturii şi fixare internă, datorită deplasării fragmentelor osoase. Pacientul a fost operat în anestezie combinată generală şi bloc de plex brahial în abord supraclavicular. Postoperator, pacientul a prezentat o durere disproporţionat de intensă în ciuda unui bloc anestezic, motor şi senzitiv deplin instalat. La inspecţie, antebraţul era edemaţiat, sensibil şi s-a constatat absenţa pulsului radial. La reexplorarea chirurgicală a fost evacuat un hematom voluminos rezultat prin hemostaza primară incompletă. Evoluţia ulterioară a fost fără sechele. Particularitatea acestui caz este dată de prezenţa durerii disproporţionate cu distribuţie ciudată la nivelul antebraţului în prezenţa unui bloc anestezic complet instalat. Sindromul de compartiment a fost diagnosticat pe baza semnelor şi simptomelor clinice în decurs de două ore de la administrarea blocului. Tratamentul corespunzător a condus la un rezultat satisfăcător.

Supraclavicular brachial plexus block is commonly used for upper extremity surgery. Respiratory arrest in three patients with end-stage renal disease after ultrasound-guided supraclavicular brachial plexus block for creation of an arteriovenous graft over a 6-month period is presented. Patients with renal failure may represent a group at particular risk for respiratory failure following supraclavicular brachial plexus block.