ABSTRACT
Subclavius posticus muscle is a supernumerary anatomical variation of the subclavius muscle. The aim of this study was to show the possible contribution of the posticus muscle in the development of unilateral thoracic outlet syndrome (TOS) in overhead athletes, presenting hypertrophy of the dominant arm due to their sport activity. Reported here are 2 young overhead athletes complaining pain, paresthesia, weakness in the dominant upper limb, although presenting none of the main shoulder and neurological disorders. After developing subclavian vein thrombosis, TOS was suspected and finally diagnosed by dynamic magnetic resonance angiography, which also showed bilateral subclavius posticus muscle in both patients. Despite bilateral subclavius posticus, TOS was only evident in the dominant limb in which the association of hypertrophy of lateral cervical muscles, resulting from the overhead sport activity, to the subclavius posticus likely led to a significant reduction of the upper thoracic outlet space.
Subject(s)
Athletic Injuries/diagnosis , Pectoralis Muscles/pathology , Thoracic Outlet Syndrome/diagnosis , Adult , Athletic Injuries/physiopathology , Humans , Magnetic Resonance Angiography , Male , Pain , Thoracic Outlet Syndrome/physiopathology , Young AdultABSTRACT
INTRODUCTION: Surgical treatment of chronic complete acromioclavicular (AC) joint dislocation is still debated and no gold standard surgical procedure has been identified. MATERIALS AND METHODS: A retrospective series of 90 patients treated for AC dislocations is reported here. Patients were divided into three groups: group 1 receiving AC reconstruction with a Dacron vascular prosthesis; group 2 receiving AC reconstruction with LARS(®) artificial ligament; group 3 receiving conservative treatment. Follow-up was performed after 1, 6 and 15 months with plain radiographs, UCLA, SPADI and modified UCLA acromioclavicular rating scales. RESULTS: Patients treated surgically presented significant better functional outcome compared to patients treated conservatively with overall positive results in 93.3% of patients for group 2 and 53.3% of patients for group 1. However, reconstruction with Dacron vascular prosthesis presented an unacceptable high complications rate (43.3%). CONCLUSION: Our results show that anatomic AC reconstruction with LARS(®) artificial ligament resulted in both satisfactory functional outcome and low complication rate. Therefore, we recommend this procedure for the treatment of chronic complete AC dislocations.
