Late Thoracic Outlet Syndrome Following Clavicle Fracture Nonunion: A Case Report and Literature Review

Abstract

Clavicle fractures are common injuries of shoulder girdle which are often treated non-operatively. However, non-operative treatment of displaced shaft fracture may be associated with high rate of nonunion. Clavicle nonunion usually results in persistent pain and functional deficits. We would like to report a case of delayed onset Thoracic Outlet Syndrome (TOS) related to clavicle fracture nonunion. This patient had delayed onset of symptoms 10 years after clavicle fracture. Open reduction and internal fixation (ORIF) was suggested and performed to decompress thoracic outlet. Symptoms of right forearm pain and numbness were partially relieved postoperatively. Percutaneous transluminal angioplasty (CTA) with 8 × 80 mm balloon under 11 bars for 60 seconds was performed at four months following surgery due to persistent symptoms and limited restoration of blood flow.