Navigating a Complex Medical Issue
I am a 23-year-old male. In my childhood, I fractured my left clavicle, but thankfully, I didn't require surgery, and everything was fine afterward. In 2022, I sustained a fracture in my right clavicle, underwent surgery, and had six screws and a plate installed. In 2023, the plate was removed. Although I initially experienced tightness in my pectoral muscles after surgery, I was told that it was likely temporary and would improve over time. However, a year down the line, I began to suffer from shoulder pain coupled with numbness in my fingers. I consulted several doctors, who assured me that my condition had healed well. But I am concerned because my surgeon removed about 1 to 1.5 centimeters of bone, and my pain has only intensified. Recently, I've begun experiencing numbness in my face on the same side where the surgery occurred, and I feel as though my entire body is inflamed. After visiting more specialists, one suggested that I might have thoracic outlet syndrome (TOS). Interestingly, I also have a cervical rib on the same side; however, I haven’t had any issues with my left shoulder, which has left me puzzled about my symptoms. At this point, I'm unsure of my next steps. Should I consider rebreaking my clavicle and using a bone graft? What are my options? I’m running out of paths to explore. Could there be an underlying infection, or is it something else? I would greatly appreciate any guidance you could provide.
Answers (1)
3/26/2025, 1:50:45 PM
OpenHealth AI
Thank you for sharing the details of your situation. It’s understandable to feel concerned given the complexity and persistence of your symptoms. The combination of shoulder pain, finger numbness, and facial numbness, following both a significant fracture and surgery, certainly raises important questions about your recovery.
Summary of Your Situation:
- History of fractures on both clavicles, with surgery on the right side.
- Issues with shoulder pain, numbness in fingers, and now facial numbness.
- Potential diagnosis of thoracic outlet syndrome (TOS) and a cervical rib on the affected side.
Explanation:
Your symptoms could indeed align with thoracic outlet syndrome, where nerves or blood vessels in the space between your collarbone and first rib are compressed. The presence of a cervical rib could contribute to this condition, especially if it’s pressing against some nerves. The numbness in your face might indicate involvement of the nerves emerging from the neck. The inflammation you feel may also be related to these compressive issues, rather than an infection.
Next Steps:
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Physical Therapy: Consider starting a targeted physical therapy program specifically for thoracic outlet syndrome. A physiotherapist can guide you through exercises designed to improve posture, strengthen shoulder muscles, and promote proper alignment, which can help alleviate your symptoms.
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MRI or Ultrasound: If you haven’t done so recently, ask for imaging studies like an MRI or an ultrasound of the thoracic outlet region. These can help identify any structural issues contributing to your symptoms (e.g., nerve compression, blood vessel issues).
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Pain Management: In the interim, manage pain and inflammation with over-the-counter medications (like NSAIDs) as needed. A healthcare provider can help you explore other options if the pain persists.
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Follow-up with Specialists: If your symptoms do not improve, arrange follow-up appointments with a neurologist or an orthopedic specialist familiar with TOS and compare their insights. Discuss the possibility of an EMG (electromyography) to assess nerve function.
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Consider All Options: Before considering the extreme option of rebreaking the clavicle, thoroughly explore non-surgical approaches. Assess if alternative treatments like targeted injections (steroids or nerve blocks) might provide relief.
In Summary:
Focus now on non-invasive options while closely monitoring your symptoms. Keep track of any changes in your pain levels or new symptoms and communicate these with your healthcare team to ensure every option is considered. You're actively seeking solutions, and there's a path toward relief ahead. If you need more information about any specific aspect or a different direction, feel free to ask!
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