EFFECT OF SCALENOTOMY IN THE SO-CALLED SCALENUS ANTICUS SYNDROME.

Abstract

Undoubtedly the Scalenus Anticus Syndrome is a rather confusing term. It is used for a variety of conditions where the main symptoms are neurovascular disturbances in the upper limb. These can be due mainly, or partly and secondarily to pressure effect of the scalenus anterior muscle. The terms cervical rib or costoclavicular syndrome and even brachialgia are used in this connection. They only show thc multiplicity of factors involved. One thing seems to be common to all these conditions. Namely that the main symptoms, pain, paresthesia and muscular weakness, can be cured or markedly relieved by the simple operation of scalenotomy. The purpose of the present investigation is to show the results obtained by scalenotomy in cases where the perplexing condition of the so-called scalenus anticus syndrome was diagnosed or strongly suspected. Two clinical follow-up studies have been published in Finland on this subject (Ahonen and Gylling). Own Material and the Follow-Up Results: The present series consists of all the cases where scalenotomy was performed at the Orthopaedic University Clinic during the years 195163. The total material is 64 cases. The age and sex distribution of the cases will be seen in Table 1. Eight patients are known to be dead, but we have had good information from three of them. Eight patients did not answer the questionnaire. The total material available for follow-up study is therefore 51 cases. The length of the observation period is described in Table 2. This material was divided into four different groups. The first group “excellent” consists of those patients who stated that their symptoms