Results of upper plexus thoracic outlet syndrome operation.

A review of 181 patients with thoracic outlet syndrome treated in our clinic revealed that 22 (12%) showed symptoms of compression of the distal median nerve only. Although there are several distinct anatomic abnormalities involving the upper brachial plexus, a first rib resection using the transaxillary approach was found to relieve these patients' symptoms as well as it did in those who exhibited the classic findings of ulnar nerve paresthesias. A comparison of the patients' outcomes showed no appreciable differences in the results obtained in those with distal median nerve compression symptoms only, lower plexus involvement, or combined upper and lower plexus symptoms.