%0 Journal Article
%T Compression of the lower trunk of the brachial plexus by a cervical rib in two adolescent girls: case reports and surgical treatment
%A Lars B Dahlin
%A Clas Backman
%A Henrik D¨ąppe
%A Harukazu Saito
%A Anette Chemnitz
%A Kasim Abul-Kasim
%A Pavel Maly
%J Journal of Brachial Plexus and Peripheral Nerve Injury
%D 2009
%I Thieme Medical Publishers
%R 10.1186/1749-7221-4-14
%X A cervical rib, articulating into the first rib is typically an asymptomatic condition that is even discovered incidentally. Clinical symptoms from the lower trunk of the brachial plexus by the cervical rib are less frequent. In a pediatric population, a cervical rib with neurogenic symptoms is an extremely rare condition with only single cases treated and reported [1-3]. In the published case reports, resection of the first rib and the attached cervical rib has been done through an axillary or a supraclavicular approach with successful postoperative result at one month after surgery, but long-term results are not available. We present two cases with compression of the lower trunk of the brachial plexus by a cervical rib in two young girls, 11 and 16 years old. The condition was successfully treated by resection of the cervical rib through a supraclavicular approach. At one year follow-up, both patients remained free of recurrent symptoms.An 11 year old right-handed girl with a history of a bilateral tumour in the neck was referred to our hospital for a second opinion. She had previously been examined at another hospital due to a tumour on the right side. Diagnosis was based on a conventional X-ray and a biopsy which showed bone tissue. No further treatment was done. We had no information available of the diagnostic and treatment considerations from that hospital. The girl also had symptoms such as paraesthesia and pain in the middle ring and little fingers, particularly on the right side, often during night time. The history of the patient included fatigue and pain while writing and working on a computer. She had problems carrying things in the hands, especially when the arm was pulled in the axial direction. Lifting the arms above the shoulder plane elicited similar symptoms in the fingers on the right side. She experienced intolerance to cold. Range of motion in the shoulder, elbow, wrist and fingers was normal, but she expressed pain in the three ulnar fingers d
%U http://www.jbppni.com/content/4/1/14