Cervical rib causing gangrene and necessitating forearm amputation.

Abstract

Cervical ribs in humans have been described for many centuries. According to Edington,4the first recorded observation of this entity was probably by Galen. In 1742, Hunauld described a well-documented case of bilateral cervical ribs as an incidental finding. Since then, many writers have recognized the importance of this anomaly in cases manifesting peripheral neuritis, loss of strength, or vascular disturbances of the upper extremities. Extremely few cases have been reported where the vascular disturbances due to a supernumerary rib have become so severe that gangrene developed and subsequent amputation of the involved limb was required. G. Perazzo6(1933) reviewed 21 cases over the years 1815 to 1933 where gangrene of portions of the upper extremity occurred. He included a case from his own observation. Only four of these cases required amputation of portions of the upper extremities, ranging from the fingers to the entire upper limb. The