{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T13:41:28Z","timestamp":1790862088802,"version":"4.1.0"},"reference-count":40,"publisher":"SAGE Publications","issue":"1","license":[{"start":{"date-parts":[[2024,10,18]],"date-time":"2024-10-18T00:00:00Z","timestamp":1729209600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"DOI":"10.13039\/100007338","name":"Foundation for Barnes-Jewish Hospital","doi-asserted-by":"publisher","award":["TOS Research and Education Fund"],"award-info":[{"award-number":["TOS Research and Education Fund"]}],"id":[{"id":"10.13039\/100007338","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Hand (New York, N,Y.)"],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Uncertainty exists concerning the optimal utilization and effectiveness of pectoralis minor tenotomy (PMT) in neurogenic thoracic outlet syndrome (NTOS).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>Between January 2020 and July 2023, 355 patients with NTOS underwent primary surgical treatment. Prospectively collected data were analyzed retrospectively.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      Overall mean patient age was 35.9\u2009\u00b1\u20091.9 years, 76% were female, and the Quick Disabilities of the Arm, Shoulder, and Hand (QuickDASH) score at presentation was 60.3\u2009\u00b1\u20093.2, reflecting substantial disability. Surgical treatment was based on localized tenderness\/symptoms to palpation, with 322 (91%) undergoing combined supraclavicular decompression and PMT (SCD\u2009+\u2009PMT) and 33 (9%) selected for isolated PMT when findings were solely confined to the subcoracoid space. Mean operative time (29\u2009\u00b1\u20095 vs 164\u2009\u00b1\u20099 min,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2009&lt;\u2009.01) and hospital stay (0.3\u2009\u00b1\u20090.1 vs 4.0\u2009\u00b1\u20090.2 days,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2009&lt;\u2009.01) were both lower after isolated PMT, with no significant differences in postoperative complications or rehospitalization. During follow-up of 26.7\u2009\u00b1\u20091.5 months, QuickDASH scores declined by 41.2%\u2009\u00b1\u20092.3% (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2009&lt;\u2009.0001) and patient-rated outcomes were excellent in 34%, good in 41%, fair in 22%, and poor in 4%. Fewer patients had poor-rated outcomes after SCD\u2009+\u2009PMT (2%) than after isolated PMT (19%) (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2009&lt;\u2009.01). Recurrent symptoms requiring supraclavicular reoperation occurred in 16 patients after SCD\u2009+\u2009PMT (5%) and in 5 patients after isolated PMT (15%) (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2009&lt;\u2009.05).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>Pectoralis minor tenotomy (PMT) has an important role in surgical treatment of NTOS, mainly as an adjunct in combination with SCD. While highly selected patients can do well after isolated PMT as a short outpatient procedure with rapid recovery, there is a greater potential for poor outcomes and supraclavicular reoperation than after SCD\u2009+\u2009PMT.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/15589447241286240","type":"journal-article","created":{"date-parts":[[2024,10,18]],"date-time":"2024-10-18T12:04:24Z","timestamp":1729253064000},"page":"105-115","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":10,"title":["Utilization and Effectiveness of Pectoralis Minor Tenotomy in the Surgical Management of Neurogenic Thoracic Outlet Syndrome"],"prefix":"10.1177","volume":"21","author":[{"given":"Gayan","family":"De Silva","sequence":"first","affiliation":[{"name":"The Center for Thoracic Outlet Syndrome and Department of Surgery, Section of Vascular Surgery, Washington University in St. Louis School of Medicine, MO, USA"},{"name":"Department of Vascular Surgery, Cleveland Clinic, Avon-Richard E. Jacobs Health Center, OH, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J. Westley","family":"Ohman","sequence":"additional","affiliation":[{"name":"The Center for Thoracic Outlet Syndrome and Department of Surgery, Section of Vascular Surgery, Washington University in St. Louis School of Medicine, MO, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karen M.","family":"Henderson","sequence":"additional","affiliation":[{"name":"The Center for Thoracic Outlet Syndrome and Department of Surgery, Section of Vascular Surgery, Washington University in St. Louis School of Medicine, MO, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Danita M.","family":"Goestenkors","sequence":"additional","affiliation":[{"name":"The Center for Thoracic Outlet Syndrome and Department of Surgery, Section of Vascular Surgery, Washington University in St. Louis School of Medicine, MO, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard D.","family":"Meyer","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Heersink School of Medicine and University of Alabama at Birmingham, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2609-1284","authenticated-orcid":false,"given":"Robert W.","family":"Thompson","sequence":"additional","affiliation":[{"name":"The Center for Thoracic Outlet Syndrome and Department of Surgery, Section of Vascular Surgery, Washington University in St. Louis School of Medicine, MO, 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