Mirza Aleem K, Duncan Audra A
Division of Vascular and Endovascular Surgery, Mayo Clinic, Rochester, MN, USA.
J Surg Case Rep. 2017 Jun 7;2017(6):rjx100. doi: 10.1093/jscr/rjx100. eCollection 2017 Jun.
Neurogenic thoracic outlet syndrome (nTOS) resulting from an isolated first rib fracture is extremely infrequent. We report a case of performance limiting nTOS in a college athlete who was initially evaluated and treated for upper extremity ligamentous injury with only transient improvement. Subsequent noninvasive studies were consistent with TOS physiology and MRA showed a large hypertrophic callus on the first rib adjacent to the brachial plexus. With continued athletic limitations and radiographic findings consistent with TOS, surgical decompression was performed resulting in resolution of symptoms. Although apparent atraumatic isolated first rib fractures are infrequently reported etiologies for TOS in athletes, they are a reasonable consideration in this population with corresponding presentations.
由孤立性第一肋骨骨折导致的神经源性胸廓出口综合征（nTOS）极为罕见。我们报告一例大学生运动员的nTOS病例，该患者最初因上肢韧带损伤接受评估和治疗，但仅获得短暂改善。随后的非侵入性检查结果与胸廓出口综合征的生理表现相符，磁共振血管造影（MRA）显示在与臂丛神经相邻的第一肋骨上有一个巨大的肥厚性骨痂。由于运动能力持续受限且影像学检查结果与胸廓出口综合征相符，遂进行了手术减压，症状得以缓解。尽管明显的无创伤性孤立性第一肋骨骨折作为运动员胸廓出口综合征的病因鲜有报道，但在有相应表现的这类人群中，应合理考虑这一病因。
