Learn the Revision Thoracic Outlet Decompression for Pectoralis Minor Syndrome surgical technique with step by step instructions on OrthOracle. Our e-learning platform contains high resolution images and a certified CME of the Revision Thoracic Outlet Decompression for Pectoralis Minor Syndrome surgical procedure.
Neurogenic thoracic outlet syndrome is characterised by a disparate collection of symptoms that may include pain, parasthaesia, or weakness in the upper limb.
Diagnosis is notoriously difficult and patients often present late after extensive investigation and sometimes after failed therapy.
Neurogenic thoracic outlet syndrome results from compromise of components of the brachial plexus as they pass through the thoracic outlet to enter the upper limb. A careful history, clinical examination, neurophysiology and imaging may help to establish the diagnosis.
Decompression of the thoracic outlet via a supraclavicular approach is effective for cases where compromise is thought to originate in the scalene triangle or the costoclavicular space.
A number of these patients however will have compression in the subpectoral space. This may exist in combination with compression more proximally or as an isolated phenomenon.
The patient in this case presented with classic symptoms of neurogenic thoracic outlet syndrome that were refractory to extensive phyiotherapy and two previous surgical procedures; a supraclavicular decompression with scalenotomy, followed by a trans-axillary first rib excision a few years later.
The following case details how one may diagnose sub-pectoral thoracic outlet syndrome (or pectoralis minor syndrome) and the surgical technique for decompressing this space.
Author: Mr Tahseen Chaudhry FRCS Tr & Orth Consultant Hand and Peripheral Nerve Surgeon
Institution: University Hospital Birmingham Birmingham, UK
Each operation and the questions associated become a named course in the CPD section
The operative technique itself is read as a lesson as is any company implant information if this is being assessed.
You’ll need to tick the box to confirm this has been done and can do this immediately if you have already read the op tech.
The vast majority of operations have a 10-15 MCQ quiz covering all aspects of the decision making and the technique
There are four possible answers of which one is correct (or on occasion more correct) than the others.
There are additional quiz modules on the surgical steps, the implants and problem cases being added continually
The course is completed once all the lessons are read and quizzes submitted and passed.
On successful completion of each quiz you will receive validated CPD points that add to the certificate in your CPD folder.
Your dashboard also will contain a record of the time you have spent logged onto and using the site.
The timer suspends after 5 minutes though if there is no activity.
When you restart you will resume at the same point in the module.
Once you have completed each quiz you will need to feedback on the module first then click “submit” and your paper will be marked.
The pass mark is 75%.
If you fall below this level you will be directed back to re-read the slides where you’ve tripped up.
Once these have been read you can re-do just the questions you failed on.
Once you have passed the quiz you can return at a future stage & resit .
CPD Points:
Operation Quiz – 1 CPD point
Surgical steps Quiz – 1/4 CPD point
Implants Quiz – 1/4 CPD point
Problem case Quiz – 1/2 CPD point
One CPD point equates to one hour of academic activity
COURSE
Welcome to the Professional Development question section. The objective of taking these tests is to demonstrate that you have understood all aspects of the assessment and management of patients requiring surgical intevention. On successful completion you will receive a certificate accredited by both the Royal College of Surgeons of both England and Edinburgh as well as the British Orthopaedic Association.
Our content is designed for both Surgeons in independent practice and Surgeons in training.
