rib lock syndrome

Introduction

Introduction to Rib Lock Syndrome The gap between the clavicle and the first rib is small and is anatomically a weak point through which the neurovascular bundle to the upper limb passes. If the shape of the clavicle or the first rib changes, the gap between the ribs will be further reduced, and the nerve vascular bundle between the compression base will produce symptoms, called the rib lock syndrome. Cervical rib syndrome is a complex clinical syndrome caused by vascular nerve compression in the thoracic outlet area. It is also known as cervical thoracic outlet syndrome (TOS), anterior scalene syndrome, pectoralis minor muscle syndrome, and rib cage syndrome. Exacerbation, excessive abduction syndrome, etc., refers to a series of upper extremity blood vessels and neurological symptoms caused by compression of brachial plexus and subclavian arteries and veins for some reason. basic knowledge Sickness ratio: 0.01%-0.02% Susceptible people: no specific population Mode of infection: non-infectious Complications: cervical rib syndrome

Cause

Cause of rib lock syndrome

Congenital factors (35%):

The first rib deformity, the normal first rib is forward and downward, but in the case of variation, the first rib is horizontal or higher, this position will compress the upper neurovascular bundle; the cervical side of the cervical thoracic segment A curved or congenital half-vertebral body can twist the upper thorax and the first rib is upward.

Poor healing after illness (27%):

The clavicle and the first rib fracture, after healing, a large number of callus or dislocation healing, the rib lock gap is reduced, and even the clavicle comminuted fracture folds the nerve or blood vessel.

Other (20%):

Subclavian muscle hypertrophy compresses nerve vessels.

Prevention

Rib lock syndrome prevention

The disease is caused by the formation of the upper limb nerve between the first rib and the clavicle, the soft tissue muscle contusion or fracture deformity around the stenotic passage through which the blood vessel passes, the bone piece, the osteophyte compression and the like, causing the upper limb neurovascular pressure to produce symptoms. It is a disease caused by traumatic factors, so there is no effective preventive measures in clinical practice. Paying attention to the safety of production and life, as well as early diagnosis and early treatment are the key to the prevention and treatment of this disease.

Complication

Rib lock syndrome complications Complications neck rib syndrome

There are few movement disorders in this disease, mainly caused by venous return of the upper chest and upper limbs, resulting in venous inflation of the place. Sometimes the brachial artery becomes weak or disappears due to the pressure pulse, and the corresponding nerve is compressed. Concomitantly, the area controlled by the nerve produces symptoms. For example, when the medial bundle is compressed, the muscles of the biceps muscle are weakened or disappeared, and the skin of the lateral side of the forearm is numb. The posterior side of the bundle is compressed by the wrist, and the muscles of the extension are weakened. The skin is numb.

Symptom

Symptoms of Rib Lock Syndrome Common Symptoms Dry skin and neck and shoulders of the skin, stiff neck and shoulder pain, upper limbs, numbness, rib pain, neck, strong purpura

The disease can produce different symptoms depending on the site being compressed:

1, nerve compression: neck and shoulder pain and discomfort, ipsilateral upper limbs have radioactive numbness, tingling, especially in the forearm and the inside of the hand.

2, vascular compression: hand intermittent pain, swelling, cold, dry skin, cyanosis, radial artery beat reduction.

Examine

Examination of the rib lock syndrome

Physical examination: When performing a physical examination, pushing the patient's shoulder joint backwards and over-extension of the patient's neck can aggravate numbness and tingling, and can also block the venous return of the upper chest and upper limbs. Insufflation, sometimes the brachial artery weakens or disappears due to the pressure pulse, and the lowering of the neck and upper limbs can alleviate the symptoms. This disease rarely causes sports disorders.

Special examination: In addition to physical examination, special examinations are required for the examination of this disease. Special tests include Wright test, Mosleg test, Edson test and Adson test.

Others: EMG and somatosensory evoked potentials can also be examined. X-ray examination is required in special cases to identify the location and organs of compression.

Diagnosis

Diagnosis and identification of rib lock syndrome

diagnosis:

The disease can be diagnosed according to clinical manifestations and X-ray examination.

Differential diagnosis:

The disease and cervical ribs, anterior scalene syndrome are very similar because of the symptoms, so it is difficult to identify from the clinical manifestations, it needs to be identified by some auxiliary examination methods. X-ray films can be used to find the lesions, thus distinguishing the cervical ribs and using blood vessels. Contrast can identify anterior scalene syndrome.

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