The cases that we are reporting are especially tragic because the elective surgeries were performed in patients who had little or no clinical abnormalities on examination prior to the surgery. Lindgren KA Rehabilitation Clinic, Kuopio University Hospital, Finland. The incidence of TOS is high in the United States, essentially unknown in Australia and seldom diagnosed in Great Britain. The reasons for this huge variation are considered to be related to difficulties in patient selection, variable examination procedures, operative techniques and a lack of proper follow-up. The goal of this review is to bring forth the diverging results after first rib resection for TOS and to pinpoint the importance of further studies concerning the possible functional disturbance of the thoracic outlet in these patients.
Conservatism is encouraged.
Lindgren KA, Oksala I Rehabilitation Clinic, Kuopio University Hospital, Finland. Even the existence of TOS is questioned and where it seems to exist, the incidence varies from one country to another. In this study 45 patients who had undergone surgery for TOS symptoms over a period of 21 years were examined by an independent clinician an average of 8 years after the operation. Forty-three percent of the performed operations were found to have been successful. Preoperative radiographic and neurophysiologic examinations were also not predictive of the outcome.