In the November, 1904, meeting of the Chicago Surgical Society, Dr. J. B. Murphy1 described the removal of a cervical rib in a patient with symptoms resembling a subclavian aneurysm. He said that there was little in the surgical literature concerning this subject, but gave H. Foote, an English surgeon, credit for the first surgical removal of a cervical rib in 1861. Since that time, many surgeons have been confronted with the problem of compression of neurovascular structures in this region by either cervical rib or the scalenus anticus muscle. The patients usually have symptoms for a long time before objective findings are present. However, we have recently seen four patients who have had ischemic necrosis of the skin or gangrene of the hand without previous symptoms of a cervical rib. In none of these patients was a cervical rib suspected, and surgical therapy was therefore delayed. We have
RUGE D, WETZEL N, BELL JL. Gangrene of the Hand as an Initial Sign of Cervical Rib. Arch Surg. 1960;81(3):367–372. doi:10.1001/archsurg.1960.01300030027004
* * SCHEDULED MAINTENANCE * *
The JAMA Network Sites will be conducting routine maintenance from 10/20/2017 through 10/21/2017. During this window access to content and authentication may be intermittently available. The JAMA Store will be completely unavailable during the maintenance window.