Thoracic Outlet decompression/ supraclavicular first rib resection


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Learn the Thoracic Outlet decompression/ supraclavicular first rib resection surgical technique with step by step instructions on OrthOracle. Our e-learning platform contains high resolution images and a certified CME of the Thoracic Outlet decompression/ supraclavicular first rib resection surgical procedure.

The thoracic outlet lies at the apex of the thorax and is traversed by the subclavian vessels and brachial plexus as they enter the upper extremity. It can be divided, conceptually, into three spaces from proximal to distal: the scalene triangle, costo-clavicular space and sub-pectoral space (lying under pectoralis minor). Thoracic outlet syndrome (TOS) is the result of compression of one or more of the neuromuscular structures at this site and is classified according to the structure being compressed as: neurogenic, arterial and venous. Neurogenic TOS remains by far the most common of these.

Clear consensus on diagnosis and treatment is still lacking. It is generally agreed that for most individuals with a diagnosis of neurogenic TOS the emphasis is on physiotherapy. Surgery is reserved for individuals who fail to respond to conservative measures. With careful patient selection surgery can be effective.

Author: Mr Simon Tan FRCS (Tr & Orth)

Institution: The Queen Elisabeth Hospital, 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.
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  • The timer suspends after 5 minutes though if there is no activity.
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    The pass mark is 75%.
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  • Once these have been read you can re-do just the questions you failed on.
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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


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.


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