Costoclavicular Syndrome Secondary to Nonunion of a Displaced Fracture of the Clavicle, Misdiagnosed as a Simple Muscle Strain: A Case Report

Thoracic outlet syndrome is a relatively common disease. However, costoclavicular syndrome as a condition secondary to nonunion of a displaced fracture of the clavicle is very rare. Most clavicular fractures in adults are united with no or minimal persistent symptoms. Also, symptomatic nonunion of a displaced fracture of the clavicle is rare. A 55-year-old male initially presented with persistent forearm pain after slip-down was initially diagnosed with simple muscle strain. However, he was given a delayed diagnosis of costoclavicular syndrome, caused by compression of the subclavian artery due to trauma in the fibrotic nonunion of the right clavicle without apparent symptoms. We obtained satisfactory results by surgical treatment. Here we report this case with a review of the literature.

Costoclavicular Syndrome: A Case Report

Costoclavicular syndrome is one of the four syndromes of thoracic outlet syndrome in which have similiar symptoms, and may result from cervical and thoracic scoliosis, formation of excessive callus or nonunion after fractures of clavicle or first rib. Conservative treatment may be offered. Surgical treatment includes scalenectomy with supraclavicular approach, transaxillary first rib resection with scalenectomy and correction of clavicular abnormality. The purpose of this paper is to evaluate the result of surgical intervention in costoclavicular syndrome of a 38-year old man with clavicular nonunion after an operation.