Supraclavicular scalenectomy for thoracic outlet syndrome--functional outcomes assessed using the DASH scoring system.
BACKGROUND
To evaluate supraclavicular scalenectomy ± cervical rib excision for thoracic outlet syndrome (TOS), employing Disability of Arm, Shoulder, and Hand (DASH) scoring for functional assessment post-decompression.


METHODS
A QuickDASH score was calculated for each patient using the algorithm: ([sum of responses/n] - 1) × 25, where n = number of completed responses. Nonparametric analysis was employed, with significance defined as P ≤ .05.


RESULTS
Twenty-one patients were treated for TOS by the same surgeon; with 5 bilateral procedures (total = 26 procedures). Median DASH scores pre- and postoperatively were 68.5 and 36.0, respectively (P = .002). Just one reported worsening of symptoms postoperatively. Antecedent trauma and smoking were inversely associated with DASH score postoperatively (P = .005 and P = .005). Postoperative scores were less for patients with vascular symptoms (P = .011); scores did not change significantly for those with neurologic (P = .066) or mixed symptoms (P = .345).


CONCLUSIONS
This study reconfirmed the value of supraclavicular approach for TOS, with the vast majority reporting subjective improvement.
Department of Vascular and Endovascular Surgery, Western Vascular Institute, Galway University Hospital, Galway, Ireland.
Ronan W
RW
Glynn
Wael
W
Tawfick
Zahrah
Z
Elsafty
Niamh
N
Hynes
Sherif
S
Sultan
D000293:Adolescent; D000328:Adult; D000465:Algorithms; D001132:Arm / Q000294:innervation*; D057070:Cervical Rib / Q000601:surgery; D019299:Decompression, Surgical / Q000379:methods*; D004185:Disability Evaluation; D005260:Female; D006225:Hand / Q000294:innervation*; D006801:Humans; D007494:Ireland; D008297:Male; D008875:Middle Aged; D009334:Neck Muscles / Q000601:surgery*; D019637:Orthopedic Procedures; D010027:Osteotomy; D011237:Predictive Value of Tests; D020127:Recovery of Function; D012782:Shoulder / Q000294:innervation*; D013901:Thoracic Outlet Syndrome / Q000175:diagnosis* / Q000503:physiopathology / Q000601:surgery*; D016896:Treatment Outcome; D055815:Young Adult